Acute Epidural Hematoma Compressing the Dominant Sigmoid Sinus as an Unusual Cause of Intracranial Hypertension: Case Report and Review of Literature
Affiliation(s)
Department of Pediatric Neurosurgery, Schneider Children’s Medical Center of Israel, Petach Tikvah, Israel. Department of Neurosurgery, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
Department of Pediatric Neurosurgery, Schneider Children’s Medical Center of Israel, Petach Tikvah, Israel. Department of Neurosurgery, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
ABSTRACT
Post traumatic dural sinus vein stenosis has been rarely described in pediatric population. We present a case of a 9-year-old child that had sustained a head injury after a fall from height causing an acute epidural hematoma compressing the dominant sigmoid sinus. The patient had developed sub acutely signs and symptoms of increased intracranial pressure. Prophylactic treatment with anticoagulants was initiated despite the presence of an intracranial bleeding. Clinical and radiological improvements were achieved. We had also reviewed the literature regarding this uncommon entity and discussed other existing diagnostic and therapeutic alternatives. Further gathering of information is essential in order to form a therapeutic protocol.
Post traumatic dural sinus vein stenosis has been rarely described in pediatric population. We present a case of a 9-year-old child that had sustained a head injury after a fall from height causing an acute epidural hematoma compressing the dominant sigmoid sinus. The patient had developed sub acutely signs and symptoms of increased intracranial pressure. Prophylactic treatment with anticoagulants was initiated despite the presence of an intracranial bleeding. Clinical and radiological improvements were achieved. We had also reviewed the literature regarding this uncommon entity and discussed other existing diagnostic and therapeutic alternatives. Further gathering of information is essential in order to form a therapeutic protocol.
Cite this paper
Rajz, G. , Zvi, I. , Cohen, J. and Michowiz, S. (2014) Acute Epidural Hematoma Compressing the Dominant Sigmoid Sinus as an Unusual Cause of Intracranial Hypertension: Case Report and Review of Literature. Open Journal of Modern Neurosurgery, 4, 76-80. doi: 10.4236/ojmn.2014.42016.
Rajz, G. , Zvi, I. , Cohen, J. and Michowiz, S. (2014) Acute Epidural Hematoma Compressing the Dominant Sigmoid Sinus as an Unusual Cause of Intracranial Hypertension: Case Report and Review of Literature. Open Journal of Modern Neurosurgery, 4, 76-80. doi: 10.4236/ojmn.2014.42016.
References
[1] Donovan, D.J. (2005) Simple Direct Skull Fracture Causing Sagittal Sinus Stenosis and Increased Intracranial Pressure: Case Report and Review of the Literature. Surgical Neurology, 63, 380-384. http://dx.doi.org/10.1016/j.surneu.2004.06.020 [2] Fuentes, S., Metellus, P., Levrier, O., Adetchessi, T., Dufour, H. and Grisoli, F. (2005) Depressed Skull Fracture Over-lying the Superior Sagittal Sinus Causing Benign Intracranial Hypertension. Description of Two Cases and Review of the Literature. British Journal of Neurosurgery, 19, 438-442.
http://dx.doi.org/10.1080/02688690500390193 [3] Yokota, H., Eguchi, T., Nobayashi, M., Nishioka, T., Nishimura, F. and Nikaido, Y. (2006) Persistent Intracranial Hypertension Caused by Superior Sagittal Sinus Stenosis Following Depressed Skull Fracture. Journal of Neurosurgery, 104, 849-852. http://dx.doi.org/10.3171/jns.2006.104.5.849 [4] Filippidis, A., Kapsalaki, E., Patramani, G. and Fountas, K.N. (2009) Cerebral Venous Sinus Thrombosis: Review of the Demographics, Pathophysiology, Current Diagnosis and Treatment. Neurosurgical Focus, 27, E3. http://dx.doi.org/10.3171/2009.8.FOCUS09167 [5] Meng, R., Dornbos, D., Meng, L., Wu, Y., Liu, Y., Li, G., Li, G., Li, S., Sun, F., Wang, X., Ding, Y. and Ji, X. (2012) Clinical Differences between Acute CVST and Non-Thrombotic CVSS. Clinical Neurology and Neurosurgery, 114, 1257-1262. http://dx.doi.org/10.1016/j.clineuro.2012.03.036 [6] Pikis, S., Moscovici, S., Itshayek, E. and Cohen, J.E. (2013) Cerebral Sinodural Thrombosis Following Minor Head Injury in Children. Journal of Clinical Neuroscience, 20, 481-484.
http://dx.doi.org/10.1016/j.jocn.2012.09.009 [7] Arac, A., Lee, M. and Steinberg, G.K. (2009) Efficacy of Endovascular Stenting in Dural Venous Sinus Stenosis for the Treatment of Idiopathic Intracranial Hypertention. Neurosurgical Focus, 27, 1-8. [8] Van Den Brink, W., Pieterman, H. and Avezaat, C.J. (1996) Sagittal Sinus Occlusion, Caused by an Overlying Depressed Cranial Fracture, Presenting with Late Signs and Symptoms of Intracranial Hypertension: Case Report. Neurosurgery, 38, 1044-1046. http://dx.doi.org/10.1097/00006123-199605000-00039 [9] Ferro, J.M., Canhao, P., Stam, J., Bousser, M.G. and Barinagarrementeria, F. (2004) Prognosis of Cerebral Vein and Dural Sinus Thrombosis. Results of the International Study on Cerebral Vein and Dural Sinus Thrombosis (ISCVT). Stroke, 35, 664-670.
http://dx.doi.org/10.1161/01.STR.0000117571.76197.26 [10] Dentali, F., Gianni, M., Crowther, M.A. and Ageno, W. (2006) Natural History of Cerebral Vein Thrombosis. Blood, 108, 1129-1134.
[1] Donovan, D.J. (2005) Simple Direct Skull Fracture Causing Sagittal Sinus Stenosis and Increased Intracranial Pressure: Case Report and Review of the Literature. Surgical Neurology, 63, 380-384. http://dx.doi.org/10.1016/j.surneu.2004.06.020 [2] Fuentes, S., Metellus, P., Levrier, O., Adetchessi, T., Dufour, H. and Grisoli, F. (2005) Depressed Skull Fracture Over-lying the Superior Sagittal Sinus Causing Benign Intracranial Hypertension. Description of Two Cases and Review of the Literature. British Journal of Neurosurgery, 19, 438-442.
http://dx.doi.org/10.1080/02688690500390193 [3] Yokota, H., Eguchi, T., Nobayashi, M., Nishioka, T., Nishimura, F. and Nikaido, Y. (2006) Persistent Intracranial Hypertension Caused by Superior Sagittal Sinus Stenosis Following Depressed Skull Fracture. Journal of Neurosurgery, 104, 849-852. http://dx.doi.org/10.3171/jns.2006.104.5.849 [4] Filippidis, A., Kapsalaki, E., Patramani, G. and Fountas, K.N. (2009) Cerebral Venous Sinus Thrombosis: Review of the Demographics, Pathophysiology, Current Diagnosis and Treatment. Neurosurgical Focus, 27, E3. http://dx.doi.org/10.3171/2009.8.FOCUS09167 [5] Meng, R., Dornbos, D., Meng, L., Wu, Y., Liu, Y., Li, G., Li, G., Li, S., Sun, F., Wang, X., Ding, Y. and Ji, X. (2012) Clinical Differences between Acute CVST and Non-Thrombotic CVSS. Clinical Neurology and Neurosurgery, 114, 1257-1262. http://dx.doi.org/10.1016/j.clineuro.2012.03.036 [6] Pikis, S., Moscovici, S., Itshayek, E. and Cohen, J.E. (2013) Cerebral Sinodural Thrombosis Following Minor Head Injury in Children. Journal of Clinical Neuroscience, 20, 481-484.
http://dx.doi.org/10.1016/j.jocn.2012.09.009 [7] Arac, A., Lee, M. and Steinberg, G.K. (2009) Efficacy of Endovascular Stenting in Dural Venous Sinus Stenosis for the Treatment of Idiopathic Intracranial Hypertention. Neurosurgical Focus, 27, 1-8. [8] Van Den Brink, W., Pieterman, H. and Avezaat, C.J. (1996) Sagittal Sinus Occlusion, Caused by an Overlying Depressed Cranial Fracture, Presenting with Late Signs and Symptoms of Intracranial Hypertension: Case Report. Neurosurgery, 38, 1044-1046. http://dx.doi.org/10.1097/00006123-199605000-00039 [9] Ferro, J.M., Canhao, P., Stam, J., Bousser, M.G. and Barinagarrementeria, F. (2004) Prognosis of Cerebral Vein and Dural Sinus Thrombosis. Results of the International Study on Cerebral Vein and Dural Sinus Thrombosis (ISCVT). Stroke, 35, 664-670.
http://dx.doi.org/10.1161/01.STR.0000117571.76197.26 [10] Dentali, F., Gianni, M., Crowther, M.A. and Ageno, W. (2006) Natural History of Cerebral Vein Thrombosis. Blood, 108, 1129-1134.