Annals of Intensive Care volume 7 , Article number: 7 Cite this article. Metrics details. Annals of Intensive Care , 7 Suppl 1 :P Introduction Head injury is a rare but possible etiology of cerebral thrombophlebitis. The diagnosis should be considered especially in front of open head injuries extended to venous sinuses. The MR angiography is the gold standard for early diagnosis. Patients and methods This is a descriptive prospective study of all trauma patients hospitalized in the intensive care unit of the University Hospital Habib Bourguiba Sfax over a period of 6 years between January and June and in whom the diagnosis of cerebral venous thrombophlebitis has been confirmed by angiography CT or MR angiography.
Results During the period study, 15 patients were included. The median age of patients was 29 [17β49] years. All patients were male, victims of poly trauma following an accident of traffic. We have noted the presence of a serious head injury in 15 patients, extended open skull fractures of the venous sinus in 9 patients. All patients underwent mechanical ventilation. The diagnosis of cerebral venous thrombosis was confirmed by cerebral angiography CT in 9 patients and cerebral MR angiography in 6 patients.
All patients did not show a contraindication against anticoagulation at diagnosis of thrombophlebitis. The thrombophilia antithrombin III, protein C and S, homocysteine, and antiphospholipid, gene mutation factors II and V as well as for anti-neutrophil cytoplasmic antibodies were negative in all patients.
The outcome was favorable in 13 patients. Two patients were died due to a state of refractory septic shock. Discussion Post traumatic cerebral thrombophlebitis is a rare thrombotic vascular disease. It must be mentioned especially with presence of extensive skull fractures in open sinuses. Venous MR angiography is the gold standard. The treatment is based on anticoagulation curative dose. Its prescription can be complicated in these cases associated with traumatic intracranial hemorrhage.
Conclusion Head injury is a rare but possible etiology of cerebral thrombophlebitis. Other prospective studies are needed to better understand the path physiology and the prognosis of these thromboses. Introduction Pain is highly prevalent in critically ill trauma patients especially those with a traumatic brain injury TBI.
