Vertex epidural hematomas caused by injury of the superior sagittal sinus

SummaryWe report on a case of vertex epidural hematomas with injury of the superior sagittal sinus due to a traffic accident. Imaging studies revealed skull fractures, subarachnoid hemorrhage, intracranial hemorrhage, epidural hematomas and injury of the superior sagittal sinus. On admission, his vital signs were normal except for pain at the site of fracture. Half an hour after admission, however, the patient’s Glasgow coma score suddenly dropped to E2M4V2. Emergent craniotomy with removal of hematomas was performed. Nine days after admission the patient had recovered well and was discharged with no neurological deficits. Cases of traumatic brain injury have been reported before, and this type of clinical presentation with sudden change in consciousness is not rare. Vertex epidural hematomas with injury to the superior sagittal sinus requires special attention, however, because it has a varied clinical course. We present this case in the hope of helping others avoid misdiagnosing or delaying treatment in the future.