Venous Injury in Patients with Blunt Traumatic Brain Injury: Retrospective Analysis of a National Cohort

Hoffman, Haydn; Otite, Fadar O; Chin, Lawrence S.

doi:10.1007/s12028-021-01265-6

Cited by 2 publications

(8 citation statements)

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“…In addition, a large registry-based study of 1,792 adult patients with CVSP found that sinus injury was associated with in-hospital stroke of any type, but the registry data used did not distinguishing between arterial and venous stroke ( 11 ). Table 4 summarizes the reported venous infarction rates.…”

Section: Resultsmentioning

confidence: 99%

“…Adjusted risk of mortality in groups of patients with CVST and TBI, compared to in groups of patients with TBI alone, were available from three of the included studies ( 9 – 11 ). All three studies included either adult patients only or patients of all ages, hence no adjusted mortality data was available from pediatric only populations.…”

Section: Resultsmentioning

confidence: 99%

“…In another study also based on national trauma bank data, Hoffman et al found a significant association between CVSP and risk of in-hospital mortality [OR 1.38 (95% CI 1.19–1.60, p < 0.001)] ( 11 ). In this study, 1,792 patients with CVSP were identified using abbreviated injury scale (AIS) coding for sinus injury from a total cohort of 619,659 patients with blunt TBI.…”

Section: Resultsmentioning

confidence: 99%

“…(Q2.1: In TBI patients, does the presence of CVST, compared to absence of CVST, have an effect on mortality?) Adjusted mortality rates were available from three studies of all-age/adult populations (9)(10)(11), while unadjusted mortality rates were reported by a number of the included studies. In-hospital mortality was the most consistently reported mortality rate in 13 of the included studies (4,6,9,10,(17)(18)(19)(20)(21)(22)(23)(24)(25), while mortality data at set time intervals (e.g., 30-day mortality) and functional outcome measures (e.g., Glasgow outcome scale) were less consistently reported between studies.…”

Section: E Ect On Mortality (Topic )mentioning

confidence: 99%

“…In a recently published systematic review and meta-analysis evaluating the prevalence of CVST in TBI ( 8 ), a pooled frequency of CVST of 26.2% was found among TBI patients with skull fractures adjacent to a cerebral venous sinus. However, the effect of CVST on TBI patients is not well-established, although several recent studies have indicated that CVST is associated with increased risk of mortality ( 9 – 11 ). These indications that CVST may not be uncommon and not necessarily benign in the setting of TBI, lead to challenges in the clinical setting.…”

Section: Introductionmentioning

confidence: 99%

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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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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: E Ect On Mortality (Topic )mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

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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Variations in the Neurosurgical Management of Depressed Skull Fractures in Adults: An International Cross-Sectional Survey

Suliman

Jayakumar

Chaurasia³

et al. 2022

J Neurol Surg A Cent Eur Neurosurg

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Background and Study Aims Depressed skull fractures have been well-described since antiquity, yet its management remains controversial. Contentious issues include the use of prophylactic antibiotics and antiepileptics, the role of non-operative management, and the replacement/removal of bone fragments. Our objective was to explore the management patterns of closed and open depressed skull fractures across the world. Material and Methods A 23-item, web-based survey was distributed electronically to the members of national neurosurgical associations, and on social media platforms. The survey was open for data collection from December 2020-April 2021. Statistical calculations were performed with SPSS v22 (IBM). Results A total of 218 respondents completed the survey, representing 56 countries. With regards to open fractures, most respondents (85.8%) treated less than 50 cases annually. Most respondents (79.4%) offered prophylactic antibiotics to all patients with open fractures, with significant geographical variation (p<0.001). Less than half (48.2%) offered prophylactic antiepileptics. Almost all (>90%) reported the following indications as important for surgical management: (1) grossly contaminated wound; (2) dural penetration; (3) depth of depression; and (4) underlying contusion/haematoma with mass effect. Most respondents treated less than 50 cases of closed depressed skull fractures annually. Most European respondents (81.7%) did not offer prophylactic antiepileptics in comparison to most Asian respondents (52.7%) (p<0.001). Depth of depression, an underlying haematoma/contusion with mass effect, and dural penetration were the most important surgical indications. Conclusions There remains a great degree of uncertainty in the management strategies employed across the world in treating depressed fractures, and future work should involve multi-national randomised trials.

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Venous Injury in Patients with Blunt Traumatic Brain Injury: Retrospective Analysis of a National Cohort

Cited by 2 publications

References 20 publications

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

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

Variations in the Neurosurgical Management of Depressed Skull Fractures in Adults: An International Cross-Sectional Survey

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