Management and outcome of cerebral venous thrombosis after head trauma: A case series - 09/05/17

Doi : 10.1016/j.neurol.2017.03.025

L. Grangeon ^a,^⁎ , V. Gilard ^b, O. Ozkul-Wermester ^a, R. Lefaucheur ^a, S. Curey ^b, E. Gerardin ^c, S. Derrey ^b, D. Maltete ^a, N. Magne ^c, A. Triquenot ^a
^a Department of Neurology, Rouen University Hospital, 1, boulevard de Germont, 76000 Rouen, France
^b Department of Neurosurgery, Rouen University Hospital, 1, boulevard de Germont, 76000 Rouen, France
^c Department of Neuroradiology, Rouen University Hospital, 1, boulevard de Germont, 76000 Rouen, France

^⁎Corresponding author.

Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Tuesday 09 May 2017
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Abstract

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.

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Keywords : Cerebral sinus, Sinus thrombosis, Transsinus fracture, Head trauma, Antithrombotic therapy, Anticoagulation