Is the Elevation of Depressed Calveria over Superior Sagittal Sinus (SSS)-(No Men Land) Rightly Contraindicated?

Depressed skull fracture over superior sagittal sinus (SSS) is most common type of dural venous sinus injury with significant morbidity and mortality. Significant dural sinus injury occurs in 1.5 to 5% of all head injury cases and SSS injury accounts for 70 to 80%. Depressed skull fractures over SSS occasionally lead to occlusion of SSS, resulting in secondary intracranial hypertension and neurological deficit.  Classical teaching is to treat these cases conservatively because of risk of fatal venous haemorrhage. The use of surgical management in these cases is a matter of controversy. However, some series documented safe fracture elevation over the SSS with clinical and radiographic resolution. Here, we are reporting surgically treated three cases of SSS injury due to depressed skull fracture with good outcome. Key words: Depressed skull fracture, Dural venous sinus, Superior sagittal sinus