Traumatic dural venous sinus gas with thrombosis

Case contributed by Dr Andrew Dixon

Presentation

Head trauma.

Patient Data

Age: 45 years
Gender: Male

Scalp haematoma 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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Case information

rID: 55484
Case created: 9th Sep 2017
Last edited: 9th Sep 2017
System: Trauma
Inclusion in quiz mode: Included

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