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

Royally Flushed. Reforming Gambling to Work For, Not Against, British Columbia

In Royally Flushed: Reforming gambling to work for, not against, British Columbia, think tank Cardus shows how the lowest-income households in B.C. pay the provincial government an estimated 4% of their annual incomes through gambling – twice the proportion that the wealthiest British Columbians hand over to the government though games of chance. B.C.’s income tax system, by contrast, taxes the wealthiest families at nearly six times the rate of the province’s poorest

Royally Flushed: Reforming Gambling to Work for, Not Against, Atlantic Canada

In Royally Flushed: Reforming Gambling to Work for, Not Against, Atlantic Canada, think tank Cardus shows how the lowest-income households in the Atlantic provinces pay their provincial governments an estimated 4% of their annual incomes through gambling – twice the proportion that the wealthiest Atlantic Canadians hand over to governments though games of chance. Atlantic provinces’ income tax systems, by contrast, tax the wealthiest families at nearly 10 times the rate of the region’s poorest

Royally Flushed: Reforming gambling to work for, not against, Alberta

In Royally Flushed: Reforming gambling to work for, not against, Alberta, think tank Cardus shows how the lowest-income households in Alberta pay the provincial government an estimated 7% of their annual incomes through gambling – triple the proportion that the wealthiest Albertans hand over to the government though games of chance. Alberta’s income tax system, by contrast, taxes the wealthiest families at nearly five times the rate of the province’s poorest

Pressing Its Luck: How Ontario Lottery and Gaming Can Work For, Not Against, Low-Income Households

In this paper, we tell the story of Ontario’s involvement with gambling and explore how it got hooked. The state has not always been the leading dealer in gambling or user of the revenue it produces. In fact, gaming’s path from an illegal and suppressed activity to a legal one, and its eventual transmogrification into a lean, mean, revenue machine having the government’s full support and encouragement, was circuitous and filled with ironies and unintended consequences

Alberta Gambling Research Institute Conference 2020: Freedom, Justice and Sovereignty in Gaming

The Alberta Gambling Research Institute's 19th Annual Conference "Freedom, Justice and Sovereignty in Gaming" was scheduled to take place in March, 2020 but was cancelled due to the COVID-19 Public Health Emergency. A selection of conference presentations and research posters that were accepted for presentation at the event have been made available with the permission of the authors