Abstract Details

Title Characterization of acute traumatic cerebral venous sinus thrombosis

Topic Neuro Trauma, Critical Care, and Sports Neurology

Presentation(s) P5 - Poster Session 5 (5:30 PM-6:30 PM)

Poster/Presentation
Number 4-055

Objective To describe the clinical characteristics of traumatic venous sinus thrombosis patients seen in an urban level 1 trauma center.

Background Traumatic cerebral venous sinus thrombosis (tCVST), a rare neurovascular entity, is increasingly detected on neuroimaging and is frequently seen in association with skull fracture. Because of its co-occurrence with intracranial hemorrhage, guidelines for medical management have been highly controversial. As part of an observational study of tCVST in patients hospitalized with acute traumatic injuries, we sought to study the occurrence and clinical course of tCVST.

Design/Methods Electronic radiology reports from 2015 to 2018 were queried to identify patients who had an acute trauma series of head CT/CTV or MRI/MRV brain using the search phrase “venous sinus thrombosis”. Cases having reports with a description of tCVST were extracted and reviewed.

Results Among 265 unique records identified, 18 patients were confirmed to have had radiologic diagnosis of tCVST. Mean age was 42.1 (SD=20.4) years. Over half (12/18=66.7%) were diagnosed within 1 day of admission, with average admission GCS=11.8 (SD=3.7). Skull fractures were common, 83.3% (15/18) with temporal fractures being most common (11/15) and most associated with transverse (8/11) and sigmoid (7/11) tCVST. 16 of 18 also suffered intracranial hemorrhage including subdural, intraparenchymal and epidural hemorrhage. The most common neurologic deficit was reduced level of consciousness, 8 of 18. The most common location of tCVST was sigmoid (12/18) and transverse (12/18) sinus, followed by jugular bulb (6/18). Most patients were initiated on antithrombotic therapy (9/18) as an inpatient including aspirin (8/9), low molecular weight heparin (1/9) and warfarin (1/9).

Conclusions The sigmoid and transverse sinuses are potentially vulnerable locations for tCVST. More research is needed to guide medical management of this complex syndrome.

Authors/Disclosures
Daniel Schwartz PRESENTER	No disclosure on file
	No disclosure on file
	No disclosure on file
Vineeta Singh, MD, FAAN (University of California, San Francisco)	Dr. Singh has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for genae Americas, Inc. .

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