Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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Early Spontaneous Recanalization of Sigmoid Sinus Thrombosis Following a Closed Head Injury in a Pediatric Patient : A Case Report and Review of Literature

  • Yun, Jung-Ho (Department of Neurological Surgery, Dankook University College of Medicine) ;
  • Ko, Jung Ho (Department of Neurological Surgery, Dankook University College of Medicine) ;
  • Lee, Mee Jeong (Department of Pediatrics, Dankook University College of Medicine)
  • Received : 2014.08.25
  • Accepted : 2015.03.02
  • Published : 2015.08.28
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Abstract

Cerebral venous sinus thrombosis (CVST) following a closed head injury in pediatric patients is a rare condition, and an early spontaneous recanalization of this condition is extremely rare. A 10-year-old boy was admitted with a mild, intermittent headache and nausea five days after a bicycle accident. The brain computed tomography showed an epidural hematoma at the right occipital area with pneumocephalus due to a fracture of the occipital skull bone. The brain magnetic resonance imaging and the magnetic resonance venography demonstrated a flow signal loss from the right sigmoid sinus to the right jugular vein. The diagnosis was sigmoid sinus thrombosis, so close observations were selected as a treatment for the patient because of his gradually improving symptoms; however, he complained of vomiting 14 days the after conservative treatment. The patient was readmitted for a further examination of his symptoms. The laboratory and the gastroenterological examinations were normal. Due to concern regarding the worsening of the sigmoid sinus thrombosis, the brain magnetic resonance venography was rechecked and it revealed the recanalization of the venous flow in the sigmoid sinus and in the jugular vein.

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References

  1. Awad AW, Bhardwaj R : Acute posttraumatic pediatric cerebral venous thrombosis : case report and review of literature. Surg Neurol Int 5 : 53, 2014 https://doi.org/10.4103/2152-7806.130908
  2. Barnes C, Newall F, Furmedge J, Mackay M, Monagle P : Cerebral sinus venous thrombosis in children. J Paediatr Child Health 40 : 53-55, 2004 https://doi.org/10.1111/j.1440-1754.2004.00291.x
  3. Bishop FS, Finn MA, Samuelson M, Schmidt RH : Endovascular balloon angioplasty for treatment of posttraumatic venous sinus thrombosis. Case report. J Neurosurg 111 : 17-21, 2009 https://doi.org/10.3171/2009.2.JNS08491
  4. Brors D, Schafers M, Schick B, Dazert S, Draf W, Kahle G : Sigmoid and transverse sinus thrombosis after closed head injury presenting with unilateral hearing loss. Neuroradiology 43 : 144-146, 2001 https://doi.org/10.1007/PL00006045
  5. Buonanno FS, Moody DM, Ball MR, Laster DW : Computed cranial tomographic findings in cerebral sinovenous occlusion. J Comput Assist Tomogr 2 : 281-290, 1978
  6. Dalgic A, Secer M, Ergungor F, Okay O, Akdag R, Ciliz D : Dural sinus thrombosis following head injury : report of two cases and review of the literature. Turk Neurosurg 18 : 70-77, 2008
  7. deVeber G, Andrew M, Adams C, Bjornson B, Booth F, Buckley DJ, et al. : Cerebral sinovenous thrombosis in children. N Engl J Med 345 : 417-423, 2001 https://doi.org/10.1056/NEJM200108093450604
  8. Georgoulis G, Alexiou G, Prodromou N : Sigmoid sinus thrombosis as a sequela of head injury in children and its management. World Neurosurg 81 : e7, 2014
  9. Holzmann D, Huisman TA, Linder TE : Lateral dural sinus thrombosis in childhood. Laryngoscope 109 : 645-651, 1999 https://doi.org/10.1097/00005537-199904000-00024
  10. Jackson BF, Porcher FK, Zapton DT, Losek JD : Cerebral sinovenous thrombosis in children : diagnosis and treatment. Pediatr Emerg Care 27 : 874-880; quiz 881-883, 2011 https://doi.org/10.1097/PEC.0b013e31822c9ccc
  11. Killewich LA, Bedford GR, Beach KW, Strandness DE Jr : Spontaneous lysis of deep venous thrombi : rate and outcome. J Vasc Surg 9 : 89-97, 1989 https://doi.org/10.1016/0741-5214(89)90223-1
  12. Killewich LA, Macko RF, Cox K, Franklin DR, Benjamin ME, Lilly MP, et al. : Regression of proximal deep venous thrombosis is associated with fibrinolytic enhancement. J Vasc Surg 26 : 861-868, 1997 https://doi.org/10.1016/S0741-5214(97)70101-0
  13. Lebowitz DC, Ko MW, Cameron EK, Ko PY : Cerebral sinus thrombosis in a 6-year-old boy after a minor head injury. Pediatr Emerg Care 30 : 177-179, 2014 https://doi.org/10.1097/PEC.0000000000000088
  14. Markel A, Meissner M, Manzo RA, Bergelin RO, Strandness DE Jr : Deep venous thrombosis : rate of spontaneous lysis and thrombus extension. Int Angiol 22 : 376-382, 2003
  15. Meissner MH, Zierler BK, Bergelin RO, Chandler WL, Strandness DE Jr : Coagulation, fibrinolysis, and recanalization after acute deep venous thrombosis. J Vasc Surg 35 : 278-285, 2002 https://doi.org/10.1067/mva.2002.121066
  16. Muthukumar N : Uncommon cause of sinus thrombosis following closed mild head injury in a child. Childs Nerv Syst 21 : 86-88, 2005 https://doi.org/10.1007/s00381-004-0926-2
  17. Nehme J, Decarie JC, Saliba I : Lateral sinus thrombosis : complication of minor head injury. Int J Pediatr Otorhinolaryngol 73 : 629-635, 2009 https://doi.org/10.1016/j.ijporl.2008.10.025
  18. Ochagavia AR, Boque MC, Torre C, Alonso S, Sirvent JJ : Dural venous sinus thrombosis due to cranial trauma. Lancet 347 : 1564, 1996
  19. Saposnik G, Barinagarrementeria F, Brown RD Jr, Bushnell CD, Cucchiara B, Cushman M, et al. : Diagnosis and management of cerebral venous thrombosis : a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 42 : 1158-1192, 2011 https://doi.org/10.1161/STR.0b013e31820a8364
  20. Shigemori Y, Koshinaga M, Suma T, Nakamura S, Murata Y, Kawamata T, et al. : Jugular bulb venous thrombosis caused by mild head injury : a case report. Surg Neurol 68 : 660-664; discussion 664, 2007 https://doi.org/10.1016/j.surneu.2006.11.037
  21. Stam J : Thrombosis of the cerebral veins and sinuses. N Engl J Med 352 : 1791-1798, 2005 https://doi.org/10.1056/NEJMra042354
  22. Stiefel D, Eich G, Sacher P : Posttraumatic dural sinus thrombosis in children. Eur J Pediatr Surg 10 : 41-44, 2000 https://doi.org/10.1055/s-2008-1072321
  23. Taha JM, Crone KR, Berger TS, Becket WW, Prenger EC : Sigmoid sinus thrombosis after closed head injury in children. Neurosurgery 32 : 541-545; discussion 545-546, 1993 https://doi.org/10.1227/00006123-199304000-00008
  24. Tamimi A, Abu-Elrub M, Shudifat A, Saleh Q, Kharazi K, Tamimi I : Superior sagittal sinus thrombosis associated with raised intracranial pressure in closed head injury with depressed skull fracture. Pediatr Neurosurg 41 : 237-240, 2005 https://doi.org/10.1159/000087480
  25. Yuen HW, Gan BK, Seow WT, Tan HK : Dural sinus thrombosis after minor head injury in a child. Ann Acad Med Singapore 34 : 639-641, 2005
  26. Zhao X, Rizzo A, Malek B, Fakhry S, Watson J : Basilar skull fracture : a risk factor for transverse/sigmoid venous sinus obstruction. J Neurotrauma 25 : 104-111, 2008 https://doi.org/10.1089/neu.2007.0351

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