Grangeon L, Gilard V, Ozkul-Wermester O, Lefaucheur R, Curey S, Gerardin E, Derrey S, Maltete D, Magne N, Triquenot A
Department of Neurology, Rouen University Hospital, 1, boulevard de Germont, 76000 Rouen, France.
Department of Neurosurgery, Rouen University Hospital, 1, boulevard de Germont, 76000 Rouen, France.
Rev Neurol (Paris). 2017 Jun;173(6):411-417. doi: 10.1016/j.neurol.2017.03.025. Epub 2017 May 8.
Cerebral venous thrombosis (CVT) is an underdiagnosed complication of head trauma. To date, initiation of anticoagulation is still a matter of debate because of the risk of worsening traumatic hemorrhage. This report describes a case series of five patients admitted for head injury complicated by CVT. The main associated radiological signs were skull fractures crossing the venous sinus and adjacent traumatic hematoma. In four patients, anticoagulation was introduced within 48-72h of CVT diagnosis, with no subsequent hemorrhagic complications. The present report and data from the literature raise the question of systematic additional venoscans when confronted by associated radiological features of post-traumatic CVT. The safety of anticoagulation in selected patients is also discussed.
脑静脉血栓形成（CVT）是头部创伤的一种诊断不足的并发症。迄今为止，由于存在使创伤性出血恶化的风险，启动抗凝治疗仍是一个有争议的问题。本报告描述了一组五例因头部损伤并发CVT而入院的病例。主要相关的放射学征象是穿过静脉窦的颅骨骨折和相邻的创伤性血肿。在四名患者中，在CVT诊断后的48 - 72小时内开始抗凝治疗，随后未出现出血并发症。本报告及文献数据提出了在面对创伤后CVT的相关放射学特征时进行系统性额外静脉扫描的问题。还讨论了在选定患者中抗凝治疗的安全性。
