Traumatic Injury of Major Cerebral Venous Sinuses Associated with Traumatic Brain Injury or Head and Neck Trauma: Analysis of National Trauma Data Bank

Background—The natural history and epidemiological aspects of traumatic injury of major cerebral
venous sinuses are not fully understood. We determined the prevalence of traumatic injury of major cere‐
bral venous sinuses and impact on the outcome of patients with traumatic brain injury, and/or head and
neck trauma.
Methods—All the patients who were admitted with traumatic brain injury or head and neck trauma were
identified by ICD-9-CM codes from the National Trauma Data Bank (NTDB), using data files from 2009 to
2010. NTDB represents one of the largest trauma databases and contains data from over 900 trauma centers
across the United States. Presence of thrombosis, intimal tear, or dissection (traumatic injury) of major cer‐
ebral venous sinuses was identified in these patients by using Abbreviated Injury Scale predot codes.
Admission Glasgow Coma Scale (GCS) score, Injury Severity Score (ISS), In-hospital complications, and
treatment outcome were compared between patients with and without traumatic injury of major cerebral
venous sinuses.
Results—A total of 76 patients were identified with traumatic injury of major cerebral venous sinuses
among 453,775 patients who had been admitted with head and neck trauma. The rate of penetrating injury
was higher among patients with traumatic injury of major cerebral venous sinuses (11.8% versus 2.5%, p =
0.0001). The patients with traumatic injury of major cerebral venous sinuses had a significantly higher rate
of intracranial hemorrhage in comparison to patients without traumatic injury of major cerebral venous
sinuses. The odds of in-hospital mortality remained significantly higher for patients with traumatic injury of
major cerebral venous sinuses after adjusting for age, gender, admission GCS score, ISS injury type, and
presence of intracranial hemorrhage [odds ratio (OR): 6.929; 95% confidence interval (CI) 1.337–35.96; p
< 0.020]. The odds of discharge to nursing home remained higher for patients with traumatic injury of
major cerebral venous sinuses after adjusting for potential confounders (OR: 1.8401; 95% CI 1.18–2.85, p
< 0.0065).
Conclusion—Although infrequent, traumatic injury of major cerebral venous sinuses in head and neck
trauma is associated with higher rates of in-hospital mortality and discharge to a nursing home.