434 Concurrent Vascular and Traumatic Brain Injury: Effect on Patient Outcomes

Abstract

INTRODUCTION: Dural venous sinus thrombosis (DVST) in select populations following traumatic brain injury (TBI), including those with blunt mechanism or depressed skull fractures, have been associated with an increased risk of mortality. METHODS: We performed a retrospective case-control study of data from our institutional trauma registry from 2004-2021. Patients were divided into three groups: those with imaging confirmed DVST, those with imaging confirmed DVST and blunt cerebrovascular injury (BCVI), and a control group of TBI patients with cerebrovascular imaging without DVST or BCVI. All age groups and injury mechanisms were included with a head abbreviated injury score (AIS) of = 3. Demographics, injury characteristics, and patient outcomes were collected. Between group differences were compared with non-parametric tests as appropriate. Multivariate logistic regression was carried out to identify predictors of inpatient mortality. RESULTS: We identified 9,875 patients over the time-period with TBIs, with a 1.64% incidence of DVST and 23.4% incidence of concurrent BCVI. Despite a more severe presenting injury profile in those with DVST, the presence of DVST itself was not significantly associated with inpatient mortality (OR 1.02; 0.26-3.69). On regression analysis an occlusive DVST (OR 1.34; 1.15-1.56) and not receiving treatment (OR 1.27; 1.01-1.60) were independently associated with inpatient mortality. Significantly worse functional outcomes were observed in those with DVST+BCVI at 6-months, though a high proportion of patients achieved a GOSE of 7 or 8. CONCLUSIONS: We observed an incidence of traumatic DVST of 1.64% in a mixed population of head injured patients, with 23.4% of patients having concurrent BCVI. The presence of DVST alone was not significantly associated with inpatient mortality.