TY - JOUR
AR - JBN-2020-1-104
TI - Traumatic Fractures Involving Major Dural Venous Sinuses: A Reappraisal Study from the Tertiary Trauma Care Center in Nepal
AU - Binod , Bhattarai
AU - Sunil , Munakomi
AU - Shashi Bhushan , Sah
AU - Sangam , Shrestha
JO - Journal of Brain and Nerves
PY - 2020
DA - Tue 30, Jun 2020
SN - 2733-2284
DO - http://dx.doi.org/10.31487/j.JBN.2020.01.04
UR - https://www.sciencerepository.org/traumatic-fractures-involving-major-dural-venous-sinuses-a-reappraisal-study_JBN-2020-1-104 
KW - Fracture, venous sinuses, management, outcome
AB - 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.