Extradural haemorrhage - at vertex

Case contributed by Dr Alexandra Stanislavsky

Presentation

Dive into shallow pool.

Patient Data

Age: 30
Gender: Male
Modality: CT

The axial and coronal brain CT demonstrates an extra-axial haemorrhage at the vertex, which crosses the midline, displacing the falx and the superior saggital sinus inferiorly.  There is an overlying subgaleal haematoma, and an associated fracture involving the right parietal bone, extending into the saggital suture.

Case Discussion

This case highlights one of the features that differentiates an extradural haemorrhage from a subdural haemorrhage - that is, EDH may cross a dural reflection - in this case, the falx. Interestingly, it does not uphold the caveat that an EDH may not cross a suture line, freely crossing the saggital surture.

There is however an associated fracture extending into the saggital suture, and this and the probable injury to the superior saggital sinus, likely account for this EDH disrespecting the suture line.

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Case Information

rID: 18369
Case created: 3rd Jul 2012
Last edited: 24th Jan 2016
Tag: trauma
Inclusion in quiz mode: Included

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