Superior Sagittal Sinus Thrombectomy in Pediatric Head Injury

Area of Science:

• Neuroscience
• Pediatric Neurology
• Trauma Surgery

Background:

• Closed head injuries can cause cerebral venous sinus thrombosis (CVST) due to dural sinus disruption.
• Sagittal sinus injuries are particularly serious, potentially leading to venous infarction and severe complications.
• Pediatric head trauma can result in CVST, compromising venous drainage and causing significant neurological deficits.

Observation:

• A 2-year-old female presented with a depressed skull fracture and superior sagittal sinus (SSS) thrombosis.
• Intracranial hemorrhage contra-indicated standard anticoagulation therapy for CVST.
• The patient underwent immediate mechanical thrombectomy for SSS thrombosis.

Findings:

• Mechanical thrombectomy led to successful neurologic recovery at 9-month follow-up.
• This case represents the youngest patient documented to receive mechanical thrombectomy for traumatic SSS thrombosis.
• Mechanical thrombectomy is a viable alternative for pediatric traumatic CVST when anticoagulation is contraindicated.

Implications:

• Traumatic CVST in pediatric patients requires careful consideration of treatment options.
• Mechanical thrombectomy may be a life-saving intervention for pediatric traumatic CVST with contraindications to anticoagulation.
• Experienced neurointerventionalists can effectively manage complex cases of pediatric traumatic CVST.