Decompressive craniectomy for dural venous sinus thrombosis

Abstract

A rare event, dural sinus thrombosis occurs more frequently in young adults and children. Generally, medical treatment is the preferred option for this condition; however, if no improvement is observed with medical treatment, decompressive craniectomy is suggested as the preferred surgical intervention. A non-systematic literature search was conducted in PubMed and SCOPUS databases until June 2023, using keywords such as "Decompressive craniectomy," "Dural venous sinus thrombosis," and "Traumatic Brain Injury," along with their synonyms in both English and Spanish. The search revealed that genetic or acquired thrombophilia and the use of oral contraceptives were the most common risk factors, explaining the female predominance of this condition. Patients with dural sinus thrombosis commonly experience headaches, the intensity of which is not yet considered pathognomonic for the condition, ranging from mild to severe. Other nonspecific symptoms include nausea, vomiting, and papilledema. Thrombolytic agents are utilized to rapidly dissolve the clot, supported by interventional neuroradiology techniques to administer the agent directly at the thrombosis site. Studies have reported the effectiveness of emergent decompressive craniectomy in patients with recent onset of dural sinus thrombosis, leading to good results, especially in cases where cerebral hernia is present.

Keywords

• intracranial embolism and thrombosis
• intracranial sinus thrombosis
• decompressive craniectomy
• neurosurgery