Intracranial hypertension caused by superior sagittal sinus stenosis secondary to a depressed skull fracture: Case report and review of the literature / Hipertensión intracraneal causada por estenosis del seno sagital superior secundaria a fractura por hundimiento craneal: caso clínico y revisión de la literatura

Depressed fractures that occur on the superior sagittal sinus (SSS) cause stenosis or thrombosis of the sinus in 11.5% of cases. Despite this, the appearance of signs and symptoms derived from high intracranial pressure is an infrequent event. So far, only 17 cases of venous sinus injury causing intracranial hypertension have been documented. It is necessary to establish treatment immediately before clinical suspicion. Surgical treatment by craniectomy is a fast, effective and safe alternative according to the series. However, it is necessary to anticipate the possibility of haemorrhage in the operating room. The case of a 7-year-old girl admitted for traumatic brain injury (TBI) with the diagnosis of a left parasagittal occipital sinus fracture that stenosed the posterior third of the superior sagittal sinus is presented. Upon arrival, she was asymptomatic, and conservative management was selected. Subsequently, the patient began to present with headache, nausea, vomiting and diplopia associated with bradycardia and apnoea pauses of central origin. She underwent surgery with a craniectomy with satisfactory clinical and radiological evolution and normalization of the intracranial pressure (ICP) registry

Las fracturas por hundimiento que acontecen sobre el seno sagital superior (SSS) ocasionan estenosis o trombosis del seno en el 11,5% de los casos. Sin embargo, en raras ocasiones ocasionan hipertensión intracraneal. La revisión de la literatura aporta únicamente 17 casos de fractura sobre senos venosos provocando cuadro de hipertensión intracraneal, aunque posiblemente se trata de una entidad más frecuente de lo que cabría esperar sobre lo publicado. Es necesario establecer un tratamiento de forma inmediata ante la sospecha clínica. El tratamiento quirúrgico mediante craniectomía es una alternativa rápida, eficaz y segura según las series. Sin embargo, es necesario estar anticipado en el quirófano ante la posibilidad de sufrir hemorragia. Se presenta el caso de una niña de 7 años que ingresa por traumatismo craneoencefálico con el diagnóstico de fractura por hundimiento occipital parasagital izquierda que estenosa el tercio posterior del SSS. A su llegada se encuentra asintomática y se decide manejo conservador. Posteriormente comienza con cefalea, náuseas, vómitos y diplopía asociado a bradicardia y pausas de apnea de origen central. Es intervenida mediante craniectomía con posterior evolución clínica y radiológica satisfactoria, y normalización de la presión intracraneal

Intracranial hypertension caused by superior sagittal sinus stenosis secondary to a depressed skull fracture: Case report and review of the literature.

Depressed fractures that occur on the superior sagittal sinus (SSS) cause stenosis or thrombosis of the sinus in 11.5% of cases. Despite this, the appearance of signs and symptoms derived from high intracranial pressure is an infrequent event. So far, only 17 cases of venous sinus injury causing intracranial hypertension have been documented. It is necessary to establish treatment immediately before clinical suspicion. Surgical treatment by craniectomy is a fast, effective and safe alternative according to the series. However, it is necessary to anticipate the possibility of haemorrhage in the operating room. The case of a 7-year-old girl admitted for traumatic brain injury (TBI) with the diagnosis of a left parasagittal occipital sinus fracture that stenosed the posterior third of the superior sagittal sinus is presented. Upon arrival, she was asymptomatic, and conservative management was selected. Subsequently, the patient began to present with headache, nausea, vomiting and diplopia associated with bradycardia and apnoea pauses of central origin. She underwent surgery with a craniectomy with satisfactory clinical and radiological evolution and normalization of the intracranial pressure (ICP) registry.