Posttraumatic cerebral venous sinus thrombosis: retrospective evaluation of risk factors, management and complications [Abstract]

Oral e-Poster Presentations - Booth 2: Trauma A, September 26, 2023, 1:00 PM - 2:30 PM Background: Up to date, there is no clear consensus on the management of posttraumatic cerebral venous sinus thrombosis (CVST). The challenge to establish a guideline in this disease is complicated by various coexisting injuries. This evaluation aims to identify risk factors, management and associated complications of posttraumatic CVST. Methods: A retrospective chart review of 341 traumatic brain injury patients admitted to the neurosurgical clinic from 2020 to 2022 was performed. Of those, 13 were diagnosed with posttraumatic CVST. In these patients, trauma mechanism, associated injuries, location of the CVST as well as treatment and possible complications were evaluated. Results: Mean age was 48 years (range: 23-84), with mainly male patients (n=8; 61.5%). Trauma mechanisms are illustrated in figure 1. Skull fractures, even though not dislocated were diagnosed in 11 patients (84.5%). Only two patients (15.3%) had CVST of the sagittal superior sinus, while most were diagnosed with CVST of the transverse (n=3, 23.0%), the sigmoid (n=4, 30.6%), or both, transverse and sigmoid sinus (n=4, 30.6%). These CVST were highly associated with skull base fractures p=0.02. Traumatic intracranial hemorrhage was evident in all patients, requiring surgery in half of the cases (Table 1). Half of all cases were treated with thrombosis prophylaxis only, while the remaining 6 (46.1%) received intravenous heparin being started at day 3 on average (range 1-8), leading to a progressive bleeding with the need for hemicraniectomy in 1 patient (7.6%). Conclusions: This study addresses the difficulty and inconsistency of the posttraumatic ST treatment. Due to the association with skull base fractures, we advocate performing a CT with contrast agent in a venous phase in these patients