A Bump in the Night: A Case Report of Pediatric Epidural Hematoma Secondary to Sinus Pericranii.

Abstract

A sinus pericranii (SP) is a rare transcranial vascular malformation caused by diploic emissary veins forming an irregular connection between a dural sinus and extracranial veins. It is generally considered a benign condition with few complications1. We report the case of a 5-year-old male patient who sustained a skull fracture from head trauma with development of an epidural hematoma that was traced to an underlying ruptured SP as the source. Non-contrast computer tomography (CT) confirmed epidural hematoma. Craniotomy for evacuation revealed an emissary venous connection along the skull fracture line consistent with an SP that had ruptured. The anomalous venous channel was ligated, and the hematoma was evacuated, with good recovery. To the authors' knowledge this case represents the only instance of a SP associated with intracranial hematoma In pediatric patients presenting with post traumatic epidural hematoma, especially where the bleeding source is uncertain or non arterial, undiagnosed venous malformations such as SP should be considered. Preoperative vascular imaging and intraoperative awareness of this possibility may be important.