Introduction: Vertex epidural hematoma (VEDH) is an uncommon presentation of extra-axial hematomas and comprises 1-8% of all extradural hematomas. It can represent a surgical dilemma regarding when and how to operate, particularly considering the potential implication of the superior sagittal sinus (SSS). It is estimated that up to 85%-95% of EDHs are associated with skull fractures. Nonetheless, diastasis of cranial sutures in adults has scarce scientific reports, let alone with associated epidural hematoma. Cases: We reported a 42-year-old male patient who came with a main complaint of a lacerated wound on his head due to an accident when he repaired the truck tire. His GCS score was 15 without any neurological deficit. A Head CT scan revealed a hyperdense biconvex lesion on the frontoparietal (vertex), frontal sinus depressed fracture and diastasis fracture of the coronal suture. Craniotomy evacuated EDH and craniectomy elevated depressed fracture with cranialization of frontal sinus were performed. Postoperative there is no surgery complication. Discussion: Vertex epidural hematoma (VEDH) frequently causes a diagnostic dilemma, both clinically and radiographically. Clinically, VEDH are often indicated by elevated intracranial pressure (a headache which is usually severe and unrelenting, nausea, visual impairment, and vomiting). Those resulted from compression of the venous outflow at the SSS and subsequently decreased absorption and outflow of cerebrospinal fluid (CSF), which may not contribute to the establishment of a specific diagnosis. Vertex fractures are present in most cases with a linear fracture line crosses (usually horizontally) the sagittal suture overlying the hematoma or diastasis of the coronal and/or sagittal suture, with or without significant external sub-galeal hematomas, indicating a vertex impact. Conclusion: Vertex epidural hematoma is a rare case. In this case, the patient had GCS score 15 without any neurological deficit. The prompt decision to surgery is vital for good outcomes for the patient with VEDH.
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