Management of Supra- and Infratentorial Epidural Hematoma in a Rural Area: A Case Report and Literature Review

A BSTRACT Traumatic brain injury (TBI) is a major cause of morbidity and mortality, with road traffic accidents as a leading contributor. Epidural hematoma (EDH) is a serious complication requiring urgent intervention. A rare subtype, supra- and infratentorial EDH (SIEDH), typically results from venous bleeding and presents unique diagnostic and surgical challenges due to its atypical location and potential sinus involvement. We report a 15-year-old male who sustained a moderate TBI in a motorcycle accident. He presented with decreased consciousness, posttraumatic seizure, and vomiting. Computed tomography imaging revealed a large SIEDH in the left occipital and cerebellar regions with midline shift. Emergency craniotomy confirmed venous bleeding from diploic veins of the occipital bone. Supra–infratentorial craniotomy was the preferred technique due to the large size of the hematoma. The patient fully recovered without neurological deficits and remained asymptomatic at 4 months. This case underscores the importance of early recognition and timely surgical intervention in SIEDH. Greater awareness of this rare condition is crucial for improving patient outcomes.