MDCT Venographic Patterns of Dural Venous Sinus Compromise After Acute Skull Fracture

Rischall, Matthew; Boegel, Kevin H.; Palmer, Christopher S.; Knoll, Barbara; McKinney, Alexander M.

doi:10.2214/ajr.15.15972

Cited by 18 publications

(12 citation statements)

References 25 publications

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“…Prior studies have established skull fractures as a risk factor for DVST, [9][10][11]17,26 and the results from our study support this. We show a strong association between skull fractures extending to a dural venous sinus and sinus thrombosis.…”

Section: Traumatic Intrasinus Gas Predicts Dvstsupporting

confidence: 89%

Traumatic dural venous sinus gas predicts a higher likelihood of dural venous sinus thrombosis following blunt head trauma

Dixon

Kavnoudias

et al. 2019

J Med Imag Rad Onc

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Introduction The aim of this study was to assess the association between intrasinus gas and dural venous sinus thrombosis (DVST) in patients with blunt head trauma. Methods One hundred and two consecutive patients with blunt head trauma imaged with non‐enhanced CT and CT head venography at our institution between 1 July 2011 and 30 June 2016 were included. Image review was performed by two independent reviewers to assess for the presence of intrasinus or perisinus gas and DVST. Skull fractures involving a dural venous sinus, sinus hyperdensity, extraaxial haematoma, and/or extrinsic dural venous sinus compression were also recorded. Univariate and multivariate analyses estimated the associations between the imaging variables and DVST. Results Thirty‐seven cases of DVST were confirmed with CT venography: 10 (27.0%) occlusive, and 27 (73.0%) non‐occlusive. We detected 24 cases of intrasinus gas, all occurring with skull fractures. Gas localized to the sinus involved by the fracture in 23 (95.8%) of 24 cases. Additional gas within a contiguous sinus was present in nine (37.5%) cases. The association between intrasinus gas and DVST of the respective sinus was statistically significant (OR: 11.3, CI: 3.9–32.9, P < 0.0001). DVST was also significantly associated with the presence of a skull fracture (P = 0.04), fractures involving the sigmoid sinus (P = 0.0001), and sinus hyperdensity (P < 0.0001). Conclusion Traumatic intrasinus gas is associated with DVST in patients with blunt head trauma. Its detection on non‐enhanced CT examinations in the emergency care setting infers a higher risk of DVST and should prompt consideration of CT venography.

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Section: Traumatic Intrasinus Gas Predicts Dvstsupporting

confidence: 89%

Traumatic dural venous sinus gas predicts a higher likelihood of dural venous sinus thrombosis following blunt head trauma

Dixon

Kavnoudias

et al. 2019

J Med Imag Rad Onc

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“…Rischall et al evaluated CTV interobserver reliability in the setting of TBI and found a strong interobserver reliability among three neuroradiologists (κ = 0.627–0.772; p < 0.0001) ( 26 ). The most common source of disagreement reported was between categories of solely sinus compression and indeterminate thrombosis/compression.…”

Section: Resultsmentioning

confidence: 99%

“…Sporadic reports that CVST can also develop with a delay after TBI were identified. Rischall et al performed follow-up CT venography within 30 days post-trauma in 28/107 patients and noted 2/28 patients with delayed venous thrombosis ( 26 ).…”

Section: Resultsmentioning

confidence: 99%

Cerebral venous sinus thrombosis in traumatic brain injury: A systematic review of its complications, effect on mortality, diagnostic and therapeutic management, and follow-up

Netteland

Sandset²,

Mejlænder-Evjensvold³

et al. 2023

Front. Neurol.

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ObjectiveCerebral venous sinus thrombosis (CVST) is increasingly being recognized in the setting of traumatic brain injury (TBI), but its effect on TBI patients and its management remains uncertain. Here, we systematically review the currently available evidence on the complications, effect on mortality and the diagnostic and therapeutic management and follow-up of CVST in the setting of TBI.MethodsKey clinical questions were posed and used to define the scope of the review within the following topics of complications; effect on mortality; diagnostics; therapeutics; recanalization and follow-up of CVST in TBI. We searched relevant databases using a structured search strategy. We screened identified records according to eligibility criteria and for information regarding the posed key clinical questions within the defined topics of the review.ResultsFrom 679 identified records, 21 studies met the eligibility criteria and were included, all of which were observational in nature. Data was deemed insufficiently homogenous to perform meta-analysis and was narratively synthesized. Reported rates of venous infarctions ranged between 7 and 38%. One large registry study reported increased in-hospital mortality in CVSP and TBI compared to a control group with TBI alone in adjusted analyses. Another two studies found midline CVST to be associated with increased risk of mortality in adjusted analyses. Direct data to inform the optimum diagnostic and therapeutic management of the condition was limited, but some data on the safety, and effect of anticoagulation treatment of CVST in TBI was identified. Systematic data on recanalization rates to guide follow-up was also limited, and reported complete recanalization rates ranged between 41 and 86%. In the context of the identified data, we discuss the diagnostic and therapeutic management and follow-up of the condition.ConclusionCurrently, the available evidence is insufficient for evidence-based treatment of CVST in the setting of TBI. However, there are clear indications in the presently available literature that CVST in TBI is associated with complications and increased mortality, and this indicates that management options for the condition must be considered. Further studies are needed to confirm the effects of CVST on TBI patients and to provide evidence to support management decisions.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier: PROSPERO [CRD42021247833].

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“…Early diagnosis of CVT should be in the lists of differential diagnoses whenever encountered in the young patients with unusual severe headache, with clinical arterial stroke and absence of risk factors, with intracranial hypertension or patients with hemorrhagic infarction on NCCT. The most common locations of intracranial dural venous sinuses are superior sagittal sinus followed by transverse sinus and sigmoid sinus as respectively [3] [4] [9].…”

Section: Introductionmentioning

confidence: 99%

Accuracy of Noncontrast CT Brain in Detection of Cerebral Venous Sinus Thrombosis

Chiewvit¹,

Tritrakarn²,

Nilanont³

2021

IJCM

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MDCT Venographic Patterns of Dural Venous Sinus Compromise After Acute Skull Fracture

Cited by 18 publications

References 25 publications

Traumatic dural venous sinus gas predicts a higher likelihood of dural venous sinus thrombosis following blunt head trauma

Traumatic dural venous sinus gas predicts a higher likelihood of dural venous sinus thrombosis following blunt head trauma

Cerebral venous sinus thrombosis in traumatic brain injury: A systematic review of its complications, effect on mortality, diagnostic and therapeutic management, and follow-up

Accuracy of Noncontrast CT Brain in Detection of Cerebral Venous Sinus Thrombosis

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