Venous Sinus Thrombosis in Blunt Trauma: Incidence and Risk Factors

Shira E. Slasky, Yayone Rivaud, Matthew Suberlak, Oluwole Tairu, Adam D. Fox, Pamela Ohman-Strickland, Esther Bilinisky

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

PURPOSE: The aim of our study was to determine the incidence and risk factors of dural venous sinus thrombosis and epidural hemorrhage in the setting of a blunt trauma causing a calvarial fracture crossing a dural venous sinus.

METHODS: A retrospective review of 472 blunt trauma patients with calvarial fracture crossing a dural venous sinus was performed. Two hundred ten patients who underwent computed tomography venography were identified and evaluated for the presence of dural venous sinus thrombosis and/or epidural hemorrhage. Site and displacement of fractures, as well as age, sex, Glasgow Coma Scale (GCS) score, and mechanism of injury, were considered for potential predictive value of thrombosis and/or epidural hemorrhage.

RESULTS: We found a 23% incidence of dural venous sinus thrombosis in patients with a fracture traversing a dural venous sinus. Significant predictors of thrombosis included temporal fracture (38% incidence) and skull base fracture (31% incidence). Occipital fracture not involving the skull base was associated with a significantly decreased risk of thrombosis, with an incidence of 9%. Decreased GCS score and fall from height greater than 10 feet additionally predicted dural venous sinus thrombosis. Significant predictors of epidural hemorrhage included parietal fractures and displaced fractures, although a large percentage of nondisplaced fractures in other bones demonstrated epidural hemorrhage as well.

CONCLUSIONS: Dural venous sinus thrombosis in the setting of blunt trauma with a calvarial fracture crossing a dural venous sinus has an incidence of 23%. Increased suspicion for thrombosis is warranted in patients with temporal or skull base fractures, low GCS score, and recent fall from great height.

Original languageEnglish (US)
Pages (from-to)891-897
Number of pages7
JournalJournal of Computer Assisted Tomography
Volume41
Issue number6
DOIs
StatePublished - Nov 1 2017
Externally publishedYes

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Intracranial Sinus Thrombosis
Venous Thrombosis
Glasgow Coma Scale
Hemorrhage
Incidence
Skull Base
Wounds and Injuries
Thrombosis
Skull Fractures
Phlebography
Tomography
Bone and Bones

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Slasky, S. E., Rivaud, Y., Suberlak, M., Tairu, O., Fox, A. D., Ohman-Strickland, P., & Bilinisky, E. (2017). Venous Sinus Thrombosis in Blunt Trauma: Incidence and Risk Factors. Journal of Computer Assisted Tomography, 41(6), 891-897. https://doi.org/10.1097/RCT.0000000000000620

Venous Sinus Thrombosis in Blunt Trauma : Incidence and Risk Factors. / Slasky, Shira E.; Rivaud, Yayone; Suberlak, Matthew; Tairu, Oluwole; Fox, Adam D.; Ohman-Strickland, Pamela; Bilinisky, Esther.

In: Journal of Computer Assisted Tomography, Vol. 41, No. 6, 01.11.2017, p. 891-897.

Research output: Contribution to journalArticle

Slasky, SE, Rivaud, Y, Suberlak, M, Tairu, O, Fox, AD, Ohman-Strickland, P & Bilinisky, E 2017, 'Venous Sinus Thrombosis in Blunt Trauma: Incidence and Risk Factors', Journal of Computer Assisted Tomography, vol. 41, no. 6, pp. 891-897. https://doi.org/10.1097/RCT.0000000000000620
Slasky, Shira E. ; Rivaud, Yayone ; Suberlak, Matthew ; Tairu, Oluwole ; Fox, Adam D. ; Ohman-Strickland, Pamela ; Bilinisky, Esther. / Venous Sinus Thrombosis in Blunt Trauma : Incidence and Risk Factors. In: Journal of Computer Assisted Tomography. 2017 ; Vol. 41, No. 6. pp. 891-897.
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N2 - PURPOSE: The aim of our study was to determine the incidence and risk factors of dural venous sinus thrombosis and epidural hemorrhage in the setting of a blunt trauma causing a calvarial fracture crossing a dural venous sinus.METHODS: A retrospective review of 472 blunt trauma patients with calvarial fracture crossing a dural venous sinus was performed. Two hundred ten patients who underwent computed tomography venography were identified and evaluated for the presence of dural venous sinus thrombosis and/or epidural hemorrhage. Site and displacement of fractures, as well as age, sex, Glasgow Coma Scale (GCS) score, and mechanism of injury, were considered for potential predictive value of thrombosis and/or epidural hemorrhage.RESULTS: We found a 23% incidence of dural venous sinus thrombosis in patients with a fracture traversing a dural venous sinus. Significant predictors of thrombosis included temporal fracture (38% incidence) and skull base fracture (31% incidence). Occipital fracture not involving the skull base was associated with a significantly decreased risk of thrombosis, with an incidence of 9%. Decreased GCS score and fall from height greater than 10 feet additionally predicted dural venous sinus thrombosis. Significant predictors of epidural hemorrhage included parietal fractures and displaced fractures, although a large percentage of nondisplaced fractures in other bones demonstrated epidural hemorrhage as well.CONCLUSIONS: Dural venous sinus thrombosis in the setting of blunt trauma with a calvarial fracture crossing a dural venous sinus has an incidence of 23%. Increased suspicion for thrombosis is warranted in patients with temporal or skull base fractures, low GCS score, and recent fall from great height.

AB - PURPOSE: The aim of our study was to determine the incidence and risk factors of dural venous sinus thrombosis and epidural hemorrhage in the setting of a blunt trauma causing a calvarial fracture crossing a dural venous sinus.METHODS: A retrospective review of 472 blunt trauma patients with calvarial fracture crossing a dural venous sinus was performed. Two hundred ten patients who underwent computed tomography venography were identified and evaluated for the presence of dural venous sinus thrombosis and/or epidural hemorrhage. Site and displacement of fractures, as well as age, sex, Glasgow Coma Scale (GCS) score, and mechanism of injury, were considered for potential predictive value of thrombosis and/or epidural hemorrhage.RESULTS: We found a 23% incidence of dural venous sinus thrombosis in patients with a fracture traversing a dural venous sinus. Significant predictors of thrombosis included temporal fracture (38% incidence) and skull base fracture (31% incidence). Occipital fracture not involving the skull base was associated with a significantly decreased risk of thrombosis, with an incidence of 9%. Decreased GCS score and fall from height greater than 10 feet additionally predicted dural venous sinus thrombosis. Significant predictors of epidural hemorrhage included parietal fractures and displaced fractures, although a large percentage of nondisplaced fractures in other bones demonstrated epidural hemorrhage as well.CONCLUSIONS: Dural venous sinus thrombosis in the setting of blunt trauma with a calvarial fracture crossing a dural venous sinus has an incidence of 23%. Increased suspicion for thrombosis is warranted in patients with temporal or skull base fractures, low GCS score, and recent fall from great height.

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