case_images: PMC9990800_01
case_images: Head computed tomography on admission. (a) Traumatic subarachnoid hemorrhage and a 1-cm thick vertex epidural hematoma overlying the superior sagittal sinus. (b and c) Parietal skull fracture reaching a diastatic fracture of the sagittal suture.
case_images: SNI-14-73-g001.jpg
case_images: PMC9990800_01_SNI-14-73-g001.jpg
case_images: F1
case_images: Computed tomography (CT) showed traumatic subarachnoid hemorrhage, a 1-cm thick VEDH overlying the SSS, and a parietal skull fracture reaching a diastatic fracture of the sagittal suture [Figure 1].
case_images: Coronal (a, c) and sagittal (b, d) head computed tomography. (a and b) Hematoma overlying the superior sagittal sinus at arrival. (c and d) The hematoma increased 1 h later.
case_images: SNI-14-73-g002.jpg
case_images: PMC9990800_01_SNI-14-73-g002.jpg
case_images: F2
case_images: Head CT 1 h (hour) later showed increased hematoma, but there was no enlargement another hour later and the patient had no exacerbation of neurological symptoms [Figures 2].
case_images: Time course of coagulation and fibrinolytic parameters. D-dimer increased progressively between admission and 3 h after injury and decreased after 3 h. Plasma fibrinogen decreased between admission and 3 h after injury but was maintained at >200 mg/dL.
case_images: SNI-14-73-g003.jpg
case_images: PMC9990800_01_SNI-14-73-g003.jpg
case_images: F3
case_images: Six units of fresh frozen plasma (FFP) were administered and fibrinogen concentration at 3 and 6 h after injury was maintained at >150 mg/dL [Figure 3]. The plasma fibrinogen concentration was within the normal postoperative range [Figure 3].
case_images: Illustration of the operative view. A horseshoe skin incision overlying the lesion was sketched. Burr holes were placed on each side and parasagittal craniotomy was performed, leaving a midline island of bone including the peritoneal fracture and diastatic fracture.
case_images: SNI-14-73-g004.jpg
case_images: PMC9990800_01_SNI-14-73-g004.jpg
case_images: F4
case_images: A horseshoe skin incision overlying the lesion was sketched [Figure 4].
case_images: Coronal (a) and sagittal (b) head computed tomography. Postoperatively, there was no residual hematoma, no recurrence of contusion, and decompression of brain tissue.
case_images: SNI-14-73-g005.jpg
case_images: PMC9990800_01_SNI-14-73-g005.jpg
case_images: F5
case_images: Postoperative head CT showed no residual hematoma and no recurrence of hemorrhage and contusion [Figure 5].