Horse shoe appearance of vertex extradural hematoma

Vertex epidural hematomas (VEDHs) are well-known subtype of extradural hemorrhage, their clinical presentation can be misleading and these lesions may be missed by routine CT axial scanning. In the presented case we describe a case of 35-year man who had a large hyperdense collection with horse shoe shaped distribution on axial images. Sagittal and coronal reconstruction of the images showed greater details of the vertex extradural hematoma. 3D CT reconstruction showed diastasis of the coronal suture with fracture lines involving parietal bones. While the patient was waiting for the surgery he developed weakness of both lower limbs. The patient underwent evacuation of extradural hematoma in emergency. It is recommended to obtain CT slices until the bone of vertex in head injury patients so the diagnosis of VEDH should not be missed.