0:01

I don't want to overemphasize the point, but this

0:03

is another example of transverse sinus injury

0:08

leading to the presence of an epidural hematoma.

0:12

Once again, we see a blood collection, which

0:16

is in the posterior fossa, along the cerebellum,

0:20

which spans across the transverse sinus, and the

0:25

blood collection is also in the occipital region.

0:27

You notice that there is, uh, small LOEs of air.

0:31

This is because the patient has had a fracture, which

0:34

we see better on the bone windows in this location, and

0:40

there is leaking of blood from this transverse sinus.

0:44

One of the important points to make about transverse

0:47

sinus injuries is that it is incredibly difficult

0:51

for the surgeons to repair the transverse sinus.

0:54

And not have issues with

0:57

potential thrombosis or stenosis.

1:00

Remember that if you have a thrombosis of

1:04

the transverse sinus, it may lead to either a

1:07

cerebellar or temporal lobe venous infarction.

1:12

And for that reason, epidural hematomas from

1:15

sinus injuries have a worse prognosis than

1:19

epidural hematomas from middle meningeal artery.

1:24

Injury.

1:25

The middle meningeal artery does not supply the brain.

1:27

It supplies the meninges, and therefore, if you

1:30

tie it off or occlude it, or ablate it, uh, you're,

1:34

you have a less likely possibility of having a

1:38

parenchymal brain injury than if you have an

1:42

issue with the repair of the transverse sinus.

1:45

So, worse prognosis in epidural hematomas

1:49

associated with venous sinus injuries.

Case: Epidural Hematoma from Transverse Sinus Injury, Prognosis on CT

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