Zoerner Douglas M, Reardon Taylor, Miller Brandon A
Department of Neurosurgery, University of Kentucky, Lexington, Kentucky.
Pikeville College of Osteopathic Medicine, Pikeville, Kentucky; and.
J Neurosurg Case Lessons. 2022 Jun 27;3(26):CASE22175. doi: 10.3171/CASE22175.
Cerebral venous sinus thrombosis (VST) is a complication of head injury and can be secondary to sinus compression by depressed skull fractures. Fracture elevation is a treatment option for VST secondary to extrinsic compression, but conservative management may also be effective. Venous sinuses can also be lacerated from skull fractures, resulting in epidural or subdural hematomas. The authors presented a case of sagittal sinus injury and thrombosis from a depressed skull fracture that caused a subgaleal hematoma. The injury was successfully managed conservatively.
A 14-year-old boy presented after a head injury with a diastatic, depressed parietal bone fracture. Computed tomography venogram showed disruption and occlusion of the superior sagittal sinus with a subgaleal hematoma in continuity with the injured sagittal sinus. Because of concern for hemorrhage if tamponade on the sinus was removed, the patient was treated nonsurgically. At follow-up, the sinus had recanalized and the fracture had healed.
Skull fractures with underlying sinus thrombosis can be managed conservatively with good outcome. Careful assessment for venous sinus injury should be made before undertaking fracture elevation to relieve sinus compression.
脑静脉窦血栓形成（VST）是头部损伤的一种并发症，可继发于颅骨凹陷性骨折对静脉窦的压迫。骨折复位是继发于外部压迫的VST的一种治疗选择，但保守治疗也可能有效。颅骨骨折也可导致静脉窦撕裂，从而引起硬膜外或硬膜下血肿。作者报告了1例因颅骨凹陷性骨折导致矢状窦损伤和血栓形成并引起帽状腱膜下血肿的病例。该损伤通过保守治疗成功治愈。
一名14岁男孩在头部受伤后出现颅骨顶骨分离性凹陷骨折。计算机断层扫描静脉造影显示上矢状窦中断和闭塞，帽状腱膜下血肿与受伤的矢状窦相连。由于担心移除对静脉窦的压迫会导致出血，该患者接受了非手术治疗。随访时，静脉窦再通，骨折愈合。
伴有潜在静脉窦血栓形成的颅骨骨折可通过保守治疗取得良好效果。在进行骨折复位以解除静脉窦压迫之前，应仔细评估静脉窦损伤情况。
