Post-traumatic cerebral venous sinus thrombosis – Institutional study and literature review

Abstract

BackgroundPost-traumatic cerebral venous sinus thrombosis (CVST) – incidence is rising during the last two decades, partly due to advanced imaging technologiesand partly due to accidents caused by high-velocity vehicles. Case seriesDuring a period from January 2020 to September 2020, we had 264 cases of head injury patients. On average, we receive 30 head injury cases per month, among which 50% would be severe head injury cases. We documented ten CVST cases among them. Diagnosis and managementIn severe head injuries with suspicion, CT brain with contrast done immediately to diagnose CVST. After 48 h of admission, worsening of GCS, increased severity of headache despite adequate management, worsening of CT findings as an increase in edema, and hemorrhagic transformation are all indications for repeat CTbrain with contrast. Management of CVST patients done with enoxaparin 40 mg twice a day/1.5 mg per kg in a day, for a duration of ten to fourteen days. Anticoagulants started only after 48 h of trauma. ConclusionEarly diagnosis of CVST in severe head injury patients and treatment started early (after 48 h of trauma) will help to prevent morbidity and mortality.