Bilateral Symmetrical Parietal Extradural Hematoma

The occurrence of bilateral extradural hematomas (EDH) is an uncommon consequence of craniocerebral trauma, and acute symmetrical bilateral epidural hematomas are extremely rare. We discuss the technique adopted by us for the management of this rare entity. A 55-year-old patient presented with history of fall of branch of tree on her head. She had loss of consciousness since then and had multiple episodes of vomiting. Examination of the scalp was suggestive of diffuse subgaleal hematoma. Her Glasgow coma scale was nine and there were no lateralizing signs. Her computed tomography scan showed bilateral, symmetrical, parietal EDH with diastases of coronal suture. The patient underwent bicoronal scalp flap well behind the coronal suture running across the junction of anterior two-third and posterior one-third of hematoma to gain bilateral exposure. Initially, left parietal trephine craniotomy was performed and without disturbing the blood clot, left trephine craniotomy was performed and the hematomas were evacuated. Management of bilateral EDH cases requires careful planning, adequate exposure, judicious surgical approach, and time management for good results.