CEREBRAL VENOUS SINUS THROMBOSIS: UNUSUAL CLOT-FORMING PHENOMENON POST HEAD TRAUMA

Authors

  • Khoo Im HOSPITAL SEBERANG JAYA
  • Mohamed Azlam B. Mohamed Micdhadhu
  • Seu Kean Tan
  • Irene Looi

DOI:

https://doi.org/10.32896/cvns.v6n3.1-9

Keywords:

Cerebral Venous Sinus Thrombosis, Clot, Post-trauma, Subarachnoid haemorrhage, Countercoup injury

Abstract

Introduction/ Background: Cerebral venous sinus thrombosis (CVST) is commonly seen in daily practice, especially in those with predisposing factors. Clinicians might miss the diagnosis if there is a low index of suspicion during clinical assessment of head injury cases, particularly in those without the risk factor. 

Case Report: We report a case of a post-traumatic head injury with skull fracture and subarachnoid haemorrhage complicated with delayed, countercoup cerebral venous sinus thrombosis in the context of no predisposing factor for thrombosis. He was started on anticoagulant and achieved clinical improvement within a week. 

Discussion: CVST is seen in post head trauma patients regardless of severity of the injury. Presence of neurological deficit post head injury like altered mental status, headache, vomiting or focal neurological signs like hemiparesis raised the suspicious of CVST. Occurrence of CVST can be delayed up to more than 10 days post trauma and it can happen at the opposite site of the trauma.

Conclusion: High suspicion index is needed to diagnose CVST early and subsequently early intervention or treatment could improve clinical outcome and prognosis of the patients. 

References

Asadollahi M, Ramezani M, Sakhaii E, Karimialavijeh E. A Case of Post-traumatic Cerebral Venous Sinus Thrombosis. Journal of Neurology and Neuroscience. 2016;7(4):0-.

Ragurajaprakash K, Senthilkumar R, Prabu SS, Madeswaran K, Kiruthika P. Post-traumatic cerebral venous sinus thrombosis–Institutional study and literature review. Interdisciplinary Neurosurgery. 2022 Mar 1;27:101398.

Mandeep Singh Ghuman, Pravin Salunke, Sushanta K. Sahoo, and Shabdeep Kaur. Cerebral venous sinus thrombosis in closed head trauma: A call to look beyond fractures and hematomas! J Emerg Trauma Shock. 2016 Jan-Mar; 9(1): 37–38.

doi: 10.4103/0974-2700.173865

Chiewvit P, Piyapittayanan S, Poungvarin N. Cerebral venous thrombosis: diagnosis dilemma. Neurology international. 2011 Nov;3(3): e13.

Hsu PJ, Lee CW, Tang SC, Jeng JS. Pearls & Oy-sters: Delayed traumatic intracerebral hemorrhage caused by cerebral venous sinus thrombosis. Neurology. 2014 Sep 30;83(14): e135-7.

Awad AW, Bhardwaj R. Acute posttraumatic pediatric cerebral venous thrombosis: case report and review of literature. Surgical Neurology International. 2014;5.

Lakhkar B, Lakhkar B, Singh BR, Agrawal A. Traumatic dural sinus thrombosis causing persistent headache in a child. Journal of Emergencies, Trauma and Shock. 2010 Jan;3(1):73.

Giesen PL, Rauch U, Bohrmann B, Kling D, Roqué M, Fallon JT, Badimon JJ, Himber J, Riederer MA, Nemerson Y. Blood-borne tissue factor: another view of thrombosis. Proceedings of the National Academy of Sciences. 1999 Mar 2;96(5):2311-5.

Qureshi AI, Sahito S, Liaqat J, Chandrasekaran PN, Siddiq F. Traumatic injury of major cerebral venous sinuses associated with traumatic brain injury or head and neck trauma: analysis of national trauma data bank. Journal of Vascular and Interventional Neurology. 2020 Jan;11(1):27.

Bokhari R, You E, Bakhaidar M, Bajunaid K, Lasry O, Zeiler FA, Marcoux J, Baeesa S. Dural venous sinus thrombosis in patients presenting with blunt traumatic brain injuries and skull fractures: a systematic review and meta-analysis. World Neurosurgery. 2020 Oct 1;142:495-505.

Hersh DS, Shimony N, Groves ML, Tuite GF, Jallo GI, Liu A, Garzon-Muvdi T, Huisman TA, Felling RJ, Kufera JA, Ahn ES. Pediatric cerebral venous sinus thrombosis or compression in the setting of skull fractures from blunt head trauma. Journal of Neurosurgery: Pediatrics. 2018 Mar 1;21(3):258-69.

Fujii Y, Tasaki O, Yoshiya K, Shiozaki T, Ogura H, Kuwagata Y, Sugimoto H, Sumi Y. Evaluation of posttraumatic venous sinus occlusion with CT venography. Journal of Trauma and Acute Care Surgery. 2009 Apr 1;66(4):1002-7.

Hejrati N, Ebel F, Guzman R, Soleman J. Posttraumatic cerebrovascular injuries in children. A systematic review. Child's nervous system. 2020 Feb;36(2):251-62.

Payne WN, De Jesus O, Payne AN. Contrecoup Brain Injury. 2022 May 29. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan–. PMID: 30725650.

Published

30-09-2024

How to Cite

Im, K., Mohamed Micdhadhu, M. A. B., Tan, S. K., & Irene Looi. (2024). CEREBRAL VENOUS SINUS THROMBOSIS: UNUSUAL CLOT-FORMING PHENOMENON POST HEAD TRAUMA. Journal Of Cardiovascular, Neurovascular & Stroke, 6(3), 1–9. https://doi.org/10.32896/cvns.v6n3.1-9