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CC BY-NC-ND 4.0 · J Neurol Surg Rep 2022; 83(01): e3-e7
DOI: 10.1055/s-0041-1742103
Original Article

Rupture of the Superior Sagittal Sinus in Penetrating Head Injury—Management of a Rare Trauma Mechanism

Holger Schlag
1   Centre for Spinal Surgery and Neurotraumatology, BG Unfallklinik Frankfurt am Main GmbH, Germany
,
Jonathan Neuhoff
1   Centre for Spinal Surgery and Neurotraumatology, BG Unfallklinik Frankfurt am Main GmbH, Germany
,
Jens Castein
1   Centre for Spinal Surgery and Neurotraumatology, BG Unfallklinik Frankfurt am Main GmbH, Germany
,
Christoph Hoffmann
1   Centre for Spinal Surgery and Neurotraumatology, BG Unfallklinik Frankfurt am Main GmbH, Germany
,
Frank Kandziora
1   Centre for Spinal Surgery and Neurotraumatology, BG Unfallklinik Frankfurt am Main GmbH, Germany
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Abstract

Civilian penetrating head injury caused by foreign objects is rare in Germany (Europe), but can result in complex neurovascular damage. We report on a patient who in suicidal intent inflicted on himself a penetrating brain injury near the vertex with a captive bolt gun. A laceration at the junction of the middle to the posterior third of the superior sinus occurred by bolt and bone fragments leading to critical stenosis and subsequent thrombosis. Upon surgery, the proximal and distal sinus openings were completely thrombosed. The sinus laceration was closed by suture and the intraparenchymal bone fragments were retrieved. Postoperative angiography disclosed persistent occlusion of the superior sagittal sinus. The patient did not develop any symptoms due to venous congestion (edema, hemorrhage), suggesting sufficient collateral venous outflow. The patient completely recovered despite the complexity of the lesion.

Keywords

penetrating head injury - superior sagittal sinus - penetrating brain injury - fractures


Publication History

Received: 16 September 2020

Accepted: 19 October 2021

Article published online:
10 January 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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