Presentation
Head trauma.
Patient Data
Scalp hematoma over the right lambdoid suture inferolaterally with subtle fracture of the inferior medial aspect of the mastoid air cells near the jugular foramen. Several locules of gas are present within the right sigmoid / sigmoid groove.
Subsequent contrast enhanced CT demonstrates non-opacification of the right sigmoid sinus and internal jugular vein at the skull base in keeping with thrombosis. This thrombosis has occurred at the site of gas seen on the initial non-contrast CT.
Case Discussion
A case of traumatic dural venous sinus thrombosis involving the sigmoid sinus with gas present within the sinus on initial non-contrast CT. At our institution we have found that the presence of traumatic intra-sinus gas appears strongly associated with thrombosis and therefore may be a useful CT sign in selecting patients for CT venography (manuscript submitted for publication).
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