title: Vertex epidural hematomas: imaging findings and diagnostic pitfalls.
abstract: OBJECTIVE
  Our purpose was to show the computed tomography (CT) and magnetic resonance (MR) imaging features of vertex epidural hematomas (EDHs) and emphasize pitfalls in the diagnosis of this entity.
  
  
  METHODS
  The neuroradiologic studies of four patients (CT in four, MR imaging and MR venography in one) were evaluated for EDH shape, size and appearance.
  
  
  RESULTS
  EDHs were biconvex in three patients and crescentic in one patient. CT appearances included a collection that was hyperdense (two patients), generally isodense with a few regions of hyperdensity (one patient) and mixed hyperdense and hypodense (one patient). MR imaging findings in one patient consisted of hyperintense signal on T1-weighted images and hypointense signal on T2-weighted images. Inferior displacement of the superior sagittal sinus was seen in two patients. Diagnosis of a small vertex EDH was difficult on routine axial CT in one patient, but apparent on MR imaging and MR venography.
  
  
  CONCLUSIONS
  Small vertex EDHs can be difficult to diagnose on routine CT. MR imaging or thin section CT should be performed to exclude the diagnosis in patients with trauma to the skull vertex.
authors.affiliation: Metrolina Imaging Group, Mercy Hospital, Charlotte, NC 28207, USA.
authors.forename: O L
authors.initials: OL
authors.lastname: Harbury
authors.forename: J M
authors.initials: JM
authors.lastname: Provenzale
authors.forename: D P
authors.initials: DP
authors.lastname: Barboriak
mesh_terms: D000328:Adult; D003937:Diagnosis, Differential; D005260:Female; D006407:Hematoma, Epidural, Cranial / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012886:Skull; D014057:Tomography, X-Ray Computed