Post-traumatic superior sagittal sinus thrombosis. Case report and analysis of the international literature.

Minerva Anestesiol

Intensive Care Unit, Avezzano Hospital, ASL Avezzano-Sulmona, Avezzano (L'Aquila), Italy.

Published: December 2003

The objective of this study is to focus attention on cerebral venous sinus thrombosis (CVST), a rather infrequent disease, especially when following closed head injury. Consequently we started from the clinical case report, concerning a patient admitted to our polyvalent ICU in the Hospital of Avezzano (AQ), Italy. The patient was a 15-year-old girl, that developed superior sagittal sinus (SSS) thrombosis following closed head injury (pedestrian run down by a car): owing to slow and progressive onset of deep coma with severe intracranial hypertension, emergency decompressive craniectomy was performed. The result was satisfying: patient conditions progressively improved, with return to consciousness, to good mobility and to good mental status. At present, 1 year after trauma, only mild disability is left over (right hand prehensile strength loss, and slightly moving gait). In conclusion, considering the literature data (intracerebral haematoma and deep coma are poor outcome predictors) and clinical evolution, we decided an aggressive surgical approach to save the patient's life, with satisfying results.

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