Penetrating intracranial gunshot wound transecting the right transverse sinus

A 23-year-old man sustained a gunshot wound to the posterior head. Imaging demonstrated a transection of the right transverse sinus, a retained bullet fragment and significant cerebellar oedema. The patient emergently underwent suboccipital decompression associated with brisk bleeding from the transverse sinus. Reported examples of surgical management of cerebral venous sinuses include: packing, grafting, patching and ligation. Our patient had a codominant transverse sinus and underwent successful unilateral ligation. His postoperative course was uneventful, however, he did require a ventriculoperitoneal shunt. He was subsequently discharged to rehab with a favourable outcome.