The case of an 11-year-old boy is presented who suffered a bicycle accident with a parasagittal skull fracture, a small vertex epidural hematoma, frontal contusions and a frontal subgaleal hematoma. Enlargement of the vertex epidural hematoma was diagnosed after development of a slight paraparesis on day 11 with the aid of MRI. Three percutaneous needle aspirations of the subgaleal hematoma with a total of 59 ml being evacuated led to quick recovery and disappearance of the subgaleal as well as the vertex epidural hematoma. It is speculated that both hematomas communicated via the skull fracture thus making the evacuation of the epidural hematoma by subgaleal punctures possible.

1.
Zuccarello M, Fiore DL, Trincia G, Pardatscher K, Andrioli GC: Epidural haematoma at the vertex. Acta Neurochir (Wien) 1982;66:195–206.
2.
Borzone M, Rivano C, Altomonte M, Capuzzo T: Acute traumatic vertex epidural haematomas surgically treated. Acta Neurochir (Wien) 1988;93:55–60.
3.
Meier U, Gärtner F, Knopf W, Klötzer R, Wolf O: The traumatic dural sinus injury – A clinical study. Acta Neurochir (Wien) 1992;119:91–93.
4.
Baurand C, Choux M, Naquet R, Grisoli F, Vigouroux RP: Incidences of lesions of the venous sinus in cranio-cerebral traumatology (in French). Neurochirurgie 1968;14:773–782.
5.
Borzone M, Gentile S, Perria C, Rivano C, Rosa M: Vertex epidural hematomas. Surg Neurol 1979;11:277–284.
6.
Columella F, Gaist G, Piazza G, Caraffa T: Extradural haematoma at the vertex. J Neurol Neurosurg Psychiatry 1968;31:315–320.
7.
Soyka D: Chronic epidural hematoma of the middle vertex (in German). Zentralbl Neurochir 1970;31:43–50.
8.
Bonner JT, Ward AA Jr: Vertex epidural hematoma treated by twist drill aspiration: Case report. J Neurosurg 1971;35:234–236.
9.
Correia A, Muke R: Epidural hematoma overlaying the superior sagittal sinus (in German). Acta Neurochir (Wien) 1972;27:37–44.
10.
Guha A, Perrin RG, Grossman H, Smyth HS: Vertex epidural hematomas. Neurosurgery 1989;25:824–828.
11.
Miller DJ, Steinmetz M, McCutcheon IE: Vertex epidural hematoma: Surgical versus conservative management: Two case reports and review of the literature. Neurosurgery 1999;45:621–625.
12.
Ramesh VG, Sivakumar S: Extradural hematoma at the vertex: A case report. Surg Neurol 1995;43:138–139.
13.
Plotkin FR, Burke TF: Vertex epidural hematoma: A diagnostic challenge. Ann Emerg Med 1994;24:312–315.
14.
Bullock R, Smith RM, van Dellen JR: Nonoperative management of extradural hematoma. Neurosurgery 1985;16:602–606.
15.
Weaver D, Pobereskin L, Jane JA: Spontaneous resolution of epidural hematomas: Report of two cases. J Neurosurg 1981;54:248–251.
16.
Pozzati E, Tognetti F: Spontaneous healing of acute extradural hematomas: Study of twenty-two cases. Neurosurgery 1986;18:696–700.
17.
Pang D, Horton JA, Herron JM, Wilberger JE Jr, Vries JK: Nonsurgical management of extradural hematomas in children. J Neurosurg 1983;59:958–971.
18.
Lahat E, Livne M, Barr J, Schiffer J, Eshel G: The management of epidural haematomas – Surgical versus conservative treatment. Eur J Pediatr 1994;153:198–201.
19.
Ceylan S, Kuzeyli K, Ilbay K, Akturk F: Nonoperative management of acute extradural hematomas in children. J Neurosurg Sci 1992;36:85–88.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.