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

5 Scopus citations

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

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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    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