Medknow Publications on behalf of the Neurological Society of India
Abstract
Paget′s disease of skull usually causes neurological
complications such as basilar invagination, cranial neuropathies, etc.
Occurrence of extradural hematoma in association with Paget′s
disease of skull is rare. A 48 year old man presented with headache and
right upper limb weakness, two days after a fall from scooter. CT Scan
of brain showed a large extradural hematoma at the vertex with the
cranial vault showing features of Paget′s disease. At surgery, no
skull fracture or injury to the superior sagittal sinus was evident.
There was diffuse oozing from the inner table of the skull, which
showed features of Paget′s disease. The extradural hematoma was
evacuated and the patient made good recovery.He deteriorated a few
hours after surgery. Follow up CT Scan showed diffuse brain swelling
with minimal recollection of hematoma. Re-exploration showed a small
recollection which was evacuated and the part of the oozing diseased
skull was excised. The patient recovered completely. This is the first
reported case of vertex extradural hematoma in association with the
Paget′s disease of skull. The unusual features are the absence of
skull fracture and injury to the superior sagittal sinus. The increased
vascularity of the skull due to Paget′s disease has caused the
hematoma by diffuse oozing from the inner table