Venous Sinus Thrombosis Following Repair of Compound Depressed Fractures Overlying Sinuses

Abstract
Background: Traumatic dural venous sinus injury associ-ated with depressed skull fracture is one of the most dangerous complications of traumatic brain injury, because it may be complicated during repair by fatal venous bleeding or post-operatively with venous sinus thrombosis.
Aim of Study: In this research we will evaluate the inci-dence and management of venous sinus thrombosis following repair of cases of traumatic compound depressed skull fractures overlying venous sinuses.
Patients and Methods: This is a retrospective study of 40 cases of compound depressed fractures overlying dural venous sinuses, operated in the period between May 2015 to May 2016, all cases subjected to surgery for elevation of depressed skull fracture, follow-up ranged from 3 to 6 months.
Results: In 22 cases (55%) the bleeding was controlled by direct gelfoam compression, in 10 cases (25%) the bleeding was controlled by direct stitching of the dural tear followed by gelfoam compression, in 6 cases (15%) the bleeding was controlled by pericranium duroplasty, 2 cases (5%) bleeding was controlled by free muscle duroplasty.
Two cases (5%) developed complete obstruction of the venous sinus, the 2 cases were operated by pericranium duroplasty, both were early managed with anticoagulants, one of them later in the follow-up developed benign intracranial hypertension.
Conclusion: Venous sinus thrombosis uncommonly occur after repair of compound depressed skull fractures overlying venous sinuses, early management with anticoagulation will result in good outcome, thrombi in sinuses frequently recanalize with time due to fibrinolysis.