Technical Considerations and outcome of repair in Hatchet Combat Injury to Cerebral Venous Sinuses | [Annals of the Pakistan Institute of Medical Sciences • 2017]

Author(s):

1. Fahmida Arab Mallah: Peoples University of Medical and Health Sciences, Shaheed Benazir Abad, Nawabshah, Pakistan

2. Muhammad Khalid: SZABMU-Pakistan Institute of Medical Sciences, Islamabad, Pakistan

3. Syed Amir Shah: SZABMU-Pakistan Institute of Medical Sciences, Islamabad, Pakistan

4. Abdul Razaq Mari: Neurosurgery Peoples University of Medical and Health Sciences, Shaheed Benazir Abad, Nawabshah, Pakistan

5. Hamid Akbar Shaikh: Neurosurgery Peoples University of Medical and Health Sciences, Shaheed Benazir Abad, Nawabshah, Pakistan

6. Muzamil Dilbar: Neurosurgery, Peoples Medical College Hospital, Shaheed Benaziraad, Nawabshah, Pakistan

7. Shams Raza Brohi: Neurosurgery, Peoples University of Medical and Health Sciences, Shaheed Benazir Abad, Nawabshah, Pakistan

Abstract:

Objective: To assess and manage Hatchet combat injuries to cerebral venous sinuses with a variety of surgical methods. Study Design: Descriptive case series study Place and Duration of study: Neurosurgery Department Peoples University of Medical and Health Sciences Nawabshah and Neurosurgery department PIMS Islamabad, from 1st Aug 2014 to July 2016. Methodology: All the patients were assessed clinically and radiologically and prepared for operation with an adequate amount of blood. Injury to venous sinus injury assessed and management varied from tamponade to interposition graft depending on the site and category of cerebral venous sinus injury. Results: 15 patients of hatchet dural venous sinus injury, managed surgically which includes 3 (20%) females and 12 (80%) males with mean age of 35 years and mean GCS of 9 -12. There were 08 (53.33%) cases involving superior sagittal sinus, 02 (13.33%) transverse sinus, 02 (13.33%), sigmoid sinus 02 (13.33%); and combine sigmoid and transverse sinus injury in 01 (6.66%) patient. Out of 15 patients, bleeding was controlled by sinus compression in 08 (53.33%) patient, ligation in 03 (20%), dural grafting in 03 (20%) and repair with saphenous venous graft in 01 (6.66%) patient. There was 01 (6.66%) death in the first week of trauma, 02 (13.33%) patients had got CSF leak. Hemiplegia persisted in 02 (13.33%) patients and 01 (6.66%) patient had got complete Aphasia. Conclusion: Hatchet combat injuries to venous sinus should be managed carefully with adequate exposure of the sinuses and securing hemostasis with simple compression, ligation, dural grafting or saphenous vein interposition graft.

Page(s): 47-51

DOI: DOI not available

Published: Journal: Annals of the Pakistan Institute of Medical Sciences, Volume: 13, Issue: 1, Year: 2017

Keywords:

cerebral venous sinus injury , hatchet combat , Technical considerations , cerebral venous sinus repair

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