Superior sagittal sinus thrombosis: a complication of gunshot wound injuries to the brain

Superior sagittal sinus thrombosis (SSST) is a rare complication of non-penetrating brain injuries. However, this is not an uncommon event in those patients who have suffered a gun shot wound (GSW) to the head. Disturbances in blood flow, lead to development of SST, endothelial injury and clotting abnormalities. Complications include increased weakness, mental status changes, seizures and potential mortality. The purpose of this paper is to illustrate three cases of SSST and the need to be alert for this entity. Our cases involve three young female patients each of whom suffs:red a GSW to the head, with resultant severe brain injury. In each case, severe disability ensued and imaging studies revealed the presence of the superior sagittal sinus syndrome. The cases demonstrate three different presentations and time courses of this entity, along with the appropriate treatment choices. This condition may appear in the immediate post-injury period, in the post-acute rehabilitation period or even at distant follow-up; therefore, patients with TBI secondary to GSW need to be monitored for an extended time interval for clinical signs which may be indicative of SSST. © 1998 Elsevier Science Ireland Ltd.