PMC7656039_01
Axial (a) and coronal (b) computed tomography scans at presentation show a biconvex hematoma with 18-mm thickness in the left high parietal region (arrow). Lateral (c) and superior (d) views of the three-dimensional computed tomography scans show a linear fracture in the left parietal bone passing parallel to the sagittal suture. CS : coronal suture.
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F1
Coma Scale (GCS) score of 13 without any focal neurological deficits. Cranial CT revealed a biconvex intracranial hematoma with 18-mm maximum thickness in the left high parietal region and a linear fracture coursing parallel to the sagittal suture [Figure 1].
(a) Bone target coronal computed tomography scan show a fracture line passing above the thickest part of an intracranial hematoma (h). A well-developed and large diploic channel is observed near the hematoma. (b) Bone target coronal computed tomography showing the magnified view of the boxed area in A. SS : Sagittal suture. DC: Diploic channel, FL: Fracture line, H: Hematoma
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F2
A well-developed and large DC was present near the hematoma [Figure 2].
Axial (a) and coronal (b) computed tomography scans performed 12 h after the admission showing the growth of the hematoma with an increased thickness of 25 mm (arrow).
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F3
CT scan showed considerable growth of the hematoma with an increased thickness of 25 mm [Figure 3].
Intraoperative photographs on reflecting the scalp flap (a), immediately after removal of the bone flap (b), after the evacuation of the epidural hematoma (c), and after fixing the bone flap back into the original place (d) are depicted. Abnormal vasculature or injury of the dural arteries is not observed. Arrow in (b) indicates the site of a large diploic channel that was cut by the medial bone fracture caused brisk bleeds. Arrows in (a) and (d) indicate the fracture line.
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F4
The bleeds were readily controlled by plugging with bone wax [Figure 4].
(a-c) Serial bone target coronal computed tomography scans performed immediately after surgery shows the cut of a large diploic channel (DC) by the medial bone cut and other finer DCs lying in the bone flap and exhibiting air density (arrows). CL: craniotomy line, FL: fracture line, SS: sagittal suture.
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F5
CT performed immediately after surgery revealed a complete cut of the large DC, in addition to other finer DCs lying near the fracture line and exhibiting air density [Figure 5].