Traumatic Venous Sinus Thrombosis: Patient and Practice Patterns at a Major Trauma Center.

Area of Science:

• Neurology
• Radiology
• Trauma Surgery

Background:

• Traumatic brain injury (TBI) can cause venous sinus injury and thrombosis (tVST).
• tVST is associated with elevated intracranial pressure and poor patient outcomes.
• Understanding risk factors, management, and outcomes of tVST is crucial.

Purpose of the Study:

• To examine the risk factors, management strategies, and clinical outcomes of traumatic venous sinus thrombosis (tVST).

Main Methods:

• A retrospective analysis of 112 patients with tVST diagnosed via computed tomography between 2013 and 2022.
• Patients were identified through institutional radiology database searches for relevant terms.
• Diagnosis was confirmed by a board-certified neuroradiologist.

Main Results:

• The cohort (n=112) was predominantly male (76.8%) with a mean age of 44 years, often sustaining skull fractures (97.3%).
• Treatment approaches for tVST included anticoagulation (13.4%), antiplatelet therapy (34.8%), or conservative management (51.8%).
• Venous sinus recanalization occurred in 50% of patients by 6 months; however, bleeding complications were higher in anticoagulated and antiplatelet groups compared to conservative management.

Conclusions:

• Treatment choices for tVST showed significant selection bias and confounding by indication.
• Heterogeneity in monitoring and treatment practices was observed.
• Further research is necessary to establish optimal management guidelines for tVST.