- Department of Radiology, Hospital of University of Pennsylvania, Perelman School of Medicine of The University of Pennsylvania, Philadelphia, PA, USA
- Stroke Program, Department of Neurology, State University of New York at Buffalo, 100 High Street, Buffalo, NY 14202, USA
Correspondence Address:
Ashkan Mowla
Department of Radiology, Hospital of University of Pennsylvania, Perelman School of Medicine of The University of Pennsylvania, Philadelphia, PA, USA
DOI:10.4103/2152-7806.156157
Copyright: © 2015 Nabavizadeh SA. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.How to cite this article: Nabavizadeh SA, Mowla A, Bress A, Pukenas B. Thrombosis of posterior condylar vein with extension to internal jugular vein; a rare radiological finding in traumatic brain injury. Surg Neurol Int 30-Apr-2015;6:69
How to cite this URL: Nabavizadeh SA, Mowla A, Bress A, Pukenas B. Thrombosis of posterior condylar vein with extension to internal jugular vein; a rare radiological finding in traumatic brain injury. Surg Neurol Int 30-Apr-2015;6:69. Available from: http://sni.wpengine.com/surgicalint_articles/thrombosis-posterior-condylar-vein-extension-internal-jugular-vein-rare-radiological-finding-traumatic-brain-injury/
Dear Editor,
The posterior condylar canal is located posterior to the occipital condyle and transmits the posterior condylar vein, one of the largest emissary veins in the retromastoid region.[
A 50-year-old patient was brought to the emergency department following a fall from 15 steps. Initial head computed tomography (CT) scan demonstrated bilateral inferior frontal hemorrhagic contusions, traumatic subarachnoid hemorrhage in bilateral frontal and right temporal lobe, and linear occipital bone fracture extending to the posterior condylar vein on the right side. There was no extension of fracture line to the major dural venous sinuses. Subsequent CT venography (CTV) demonstrated thrombosis of right posterior condylar vein with extension to upper aspect of right internal jugular vein causing nonocclusive thrombosis [
Figure 1
Axial CT scan demonstrates linear occipital bone fracture with extension to the right posterior condylar canal (a white arrow). Axial and sagittal oblique CT Venogram (b and c) demonstrate right condylar vein thrombosis (white arrow) with extension to right internal jugular vein (black arrow)
Emissary veins connect the extracranial venous system with the intracranial venous sinuses. Although they are usually small in healthy people, they may enlarge in patients with increased intracranial pressure, in patients with high-flow vascular malformations or severe hypoplasia/aplasia or obstruction of the jugular veins. They may also serve as a conduit for retrograde spread of infection or tumors. Familiarity with major posterior fossa emissary veins is important to avoid misdiagnosis as abnormal findings and also to prevent surgical complications, which can result in intracranial hemorrhage, air embolism, and fatal increases in intracranial pressure.[
The role of traumatic close head injuries as an important etiology of cerebral venous sinus thrombosis has been demonstrated in multiple studies.[
In conclusion, in the setting of blunt head trauma, extension of the fracture lines to the posterior condylar canal can cause condylar vein thrombosis with secondary extension to major dural venous sinuses. Increase in awareness of this anatomical structure and routine CTV when there is extension of skull fracture line to the major dural sinuses is important for appropriate diagnosis.
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