Traumatic Fractures Involving Major Dural Venous Sinuses: A Reappraisal Study from the Tertiary Trauma Care Center in Nepal

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Author Info

Binod Bhattarai Sunil Munakomi Shashi Bhushan Sah Sangam Shrestha

Corresponding Author

Sunil Munakomi
Neurosurgery, College of Medical Sciences, Chitwan, Nepal

A B S T R A C T

Objective: The surgical management of compound depressed fractures overlying dural venous sinuses confers major challenges for the neurosurgeons. On one hand, the depressed fracture and associated compound wound herald the risk of venous occlusion and fatal brain swelling, on the other hand, the surgical attempt in managing them foresees major risks of bleeding and air embolism. Materials and Results: A retrospective analytical study was conducted from the hospital records pertaining to the cohorts of patients admitted with traumatic fractures overlying major dural venous sinuses. Among 45 patients included on our study, six patients were managed conservatively, and the rest 39 patients required surgical intervention due to compound depressed fractures heralding high risk of venous flow obstruction. The age of our patients ranged from 6 to 60 years with a high male predominance (77% vs. 22.22%).The most common mode of injuries was road traffic accidents in 66.67% (30/45) of cases. The most common location of depressed fracture was in the anterior third of SSS, seen in 57.77% of cases. The surgical complications were seen is 2.23% of cases, with the single instances of air embolism, profuse bleeding and cortical venous thrombosis seen respectively. The overall mortality seen in our study was 6.67%, whereas the operative mortality was only 4.45%. Conclusion: The refinement in the surgical nuances has now enabled us in managing depressed fractures overlying major dural venous sinuses with minimal risks of complications, thereby preventing the high risks of venous hypertension they otherwise invariably harbinger.

Article Info

Article Type

Research Article

Publication history

Received: Tue 19, May 2020
Accepted: Fri 12, Jun 2020
Published: Tue 30, Jun 2020

Copyright

© 2023 Sunil Munakomi. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Hosting by Science Repository.
DOI: 10.31487/j.JBN.2020.01.04