title: Vertex epidural hematoma with bilateral abducent nerve palsy: case report and literature review.
abstract: Epidural hematomas which are located at the vertex are rarely seen and form a     small percentage of total epidural hematomas. Tearing in the superior sagittal     sinus is the usual cause of an epidural hematoma located in the vertex. The     clinical features of this entity are non-specific; hence, localization of the     lesion is difficult. We report an adult who was hit by a motorcycle and was     initially discharged from the hospital as a case of concussional head injury. He     returned back with raised intracranial pressure symptoms, so a CT scan was done     but was misinterpreted, and he reported one week later with bilateral abducent     nerve palsy. Magnetic resonance imaging confirmed vertex EDH for which he was     operated.These hematomas are seen rarely and can be interpreted as an artifact.     Its recognition is important because it has an excellent prognosis. We concluded     that all head injury patients should get high axial cuts on the CT scan, and any     degree of suspicion should prompt a neurosurgeon to investigate further with     coronal CT scan or MRI.
authors.affiliation: Sher-i-Kashmir Institute of Medical Sciences, Department of Neurosurgery, Kashmir, India. nkhursh@rediffmail.com
authors.forename: Khursheed
authors.initials: K
authors.lastname: Nayil
authors.forename: Masood
authors.initials: M
authors.lastname: Laharwal
authors.forename: Anil
authors.initials: A
authors.lastname: Dhar
authors.forename: Abrar
authors.initials: A
authors.lastname: Wani
authors.forename: Altaf
authors.initials: A
authors.lastname: Ramzan
authors.forename: Sajad
authors.initials: S
authors.lastname: Arif
mesh_terms: D020434:Abducens Nerve Diseases / Q000209:etiology* / Q000601:surgery; D000328:Adult; D001930:Brain Injuries / Q000150:complications* / Q000601:surgery; D007839:Functional Laterality; D006407:Hematoma, Epidural, Cranial / Q000150:complications* / Q000175:diagnosis* / Q000601:surgery; D006801:Humans; D008297:Male