{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T12:25:56Z","timestamp":1783599956915,"version":"3.55.0"},"reference-count":64,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T00:00:00Z","timestamp":1783382400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Neuroradiol J"],"abstract":"<jats:p>Dural venous sinus injury (DVSI) can occur after traumatic brain injury and lead to impaired cerebral venous outflow through extrinsic compression, intraluminal thrombosis, or mixed mechanisms. It can progress to a sinus tear or transection with hemorrhage. On noncontrast-enhanced head CT, DVSI may be subtle and can be confounded by adjacent fractures, extra-axial blood products, and filling defects such as arachnoid granulations. Although the reported incidence of severe head injury is 1\u20134%, modern trauma imaging has revealed a substantially higher burden of DVSI and dural venous sinus thrombosis (DVST) in patients with skull base and calvarial fractures, particularly when fractures cross or overlie major sinuses or the jugular bulb. This narrative review focuses on acute post-traumatic dural venous sinus injury and synthesizes current knowledge on the angiographic anatomy. We also highlight the strengths and limitations of CT venography (CTV), MR venography (MRV), and adjunctive digital subtraction angiography in detecting DVSI, differentiating intraluminal thrombus from extrinsic compression, and characterizing collateral pathways. Finally, we review management strategies, including neurosurgical decompression for mechanically compressed sinuses, the non-standardized use of systemic anticoagulation for DVST in the presence of a hemorrhage, and the role of detailed venographic mapping for operative planning. Timely recognition of these injuries and their complications, guided by a systematic venographic approach, is essential for mechanism-based management that may reduce the risk of serious sequelae including venous infarction.<\/jats:p>","DOI":"10.1177\/19714009261467323","type":"journal-article","created":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T07:03:54Z","timestamp":1783407834000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Acute dural venous sinus injuries: Imaging and challenges"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-7056-1822","authenticated-orcid":false,"given":"Ruben Gabriel","family":"Ortiz Cordero","sequence":"first","affiliation":[{"name":"University of Florida College of Medicine - Jacksonville"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oswaldo Andr\u00e9","family":"Guevara Tirado","sequence":"additional","affiliation":[{"name":"University of Florida College of Medicine - Jacksonville"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hrishabh","family":"Bhosale","sequence":"additional","affiliation":[{"name":"University of Texas MD Anderson Cancer Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mayur","family":"Virarkar","sequence":"additional","affiliation":[{"name":"University of Florida College of Medicine - Jacksonville"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miguel","family":"Fabrega","sequence":"additional","affiliation":[{"name":"University of Texas McGovern Medical School Houston"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan Seiji","family":"Kitagawa","sequence":"additional","affiliation":[{"name":"University of Texas McGovern Medical School Houston"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emilio","family":"Supsupin","sequence":"additional","affiliation":[{"name":"University of Florida College of Medicine - Jacksonville"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,7,7]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.crad.2019.12.009"},{"key":"e_1_3_4_3_2","volume-title":"Neuroanatomy, cranial meninges","author":"Ghannam JY","year":"2025","unstructured":"Ghannam JY, Al Kharazi KA. Neuroanatomy, cranial meninges. StatPearls. Treasure Island (FL). StatPearls Publishing, 2025."},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.15.15972"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.3171\/2023.10.JNS231158"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1111\/jon.13182"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.inat.2021.101398"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2020.06.117"},{"key":"e_1_3_4_9_2","first-page":"118","article-title":"Traumatic Dural venous sinus injury","volume":"11","author":"Kim Y-S","year":"2015","unstructured":"Kim Y-S, Jung S-H, Lim D-H, et al. Traumatic Dural venous sinus injury. Korean J Nutr 2015; 11: 118\u2013123. https:\/\/doi.org\/10.13004\/kjnt.2015.11.2.118","journal-title":"Korean J Nutr"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2024.01.132"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/RCT.0000000000000620"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.10091565"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12028-025-02278-1"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2020.02.089"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.12998\/wjcc.v5.i7.292"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2022.1079579"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.1148\/rg.26si055174"},{"key":"e_1_3_4_18_2","volume-title":"Osborn\u2019s brain: imaging, pathology, and anatomy","author":"Osborn AG","year":"2018","unstructured":"Osborn AG, Hedlund GL, Salzman KL. Osborn\u2019s brain: imaging, pathology, and anatomy. 2nd ed. Elsevier, 2018.","edition":"2"},{"key":"e_1_3_4_19_2","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A2157"},{"key":"e_1_3_4_20_2","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.10.5323"},{"key":"e_1_3_4_21_2","volume-title":"Anatomy, head and neck, emissary veins","author":"Klein BM","year":"2025","unstructured":"Klein BM, Bordoni B. Anatomy, head and neck, emissary veins. StatPearls. Treasure Island (FL). StatPearls Publishing, 2025."},{"key":"e_1_3_4_22_2","volume-title":"Dural venous sinuses","author":"Bayot ML","year":"2025","unstructured":"Bayot ML, Reddy V, Neuroanatomy ZMK. Dural venous sinuses. StatPearls. StatPearls Publishing, 2025."},{"key":"e_1_3_4_23_2","first-page":"74","article-title":"Cerebral MR venography: normal anatomy and potential diagnostic pitfalls","volume":"21","author":"Ayanzen RH","year":"2000","unstructured":"Ayanzen RH, Bird CR, Keller PJ, et al. Cerebral MR venography: normal anatomy and potential diagnostic pitfalls. AJNR Am J Neuroradiol 2000; 21: 74\u201378.","journal-title":"AJNR Am J Neuroradiol"},{"key":"e_1_3_4_24_2","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.169.6.9393193"},{"key":"e_1_3_4_25_2","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.198.1.8539371"},{"key":"e_1_3_4_26_2","doi-asserted-by":"publisher","DOI":"10.5797\/jnet.ra.2020-0086"},{"key":"e_1_3_4_27_2","first-page":"150","article-title":"Microsurgical anatomy of the cavernous sinus","volume":"12","author":"Kiris T","year":"1996","unstructured":"Kiris T, Sankhla SK, Lawton MT, et al. Microsurgical anatomy of the cavernous sinus. Barrow Quarterly 1996; 12: 150\u2013163.","journal-title":"Barrow Quarterly"},{"key":"e_1_3_4_28_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-2007-985194"},{"key":"e_1_3_4_29_2","first-page":"787","article-title":"Multisection CT venography of the Dural sinuses and cerebral veins by using matched mask bone elimination","volume":"25","author":"Majoie CB","year":"2004","unstructured":"Majoie CB, van Straten M, Venema HW, et al. Multisection CT venography of the Dural sinuses and cerebral veins by using matched mask bone elimination. AJNR Am J Neuroradiol 2004; 25: 787\u2013791.","journal-title":"AJNR Am J Neuroradiol"},{"key":"e_1_3_4_30_2","volume-title":"Neuroanatomy, superior sagittal sinus","author":"Letchuman V","year":"2025","unstructured":"Letchuman V, Donohoe C. Neuroanatomy, superior sagittal sinus. StatPearls. Treasure Island (FL). StatPearls Publishing, 2025."},{"key":"e_1_3_4_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jocn.2018.08.047"},{"key":"e_1_3_4_32_2","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.13.10985"},{"key":"e_1_3_4_33_2","doi-asserted-by":"publisher","DOI":"10.1590\/1677-5449.202300362"},{"key":"e_1_3_4_34_2","doi-asserted-by":"publisher","DOI":"10.3390\/medicina60091408"},{"key":"e_1_3_4_35_2","first-page":"540","article-title":"Management of traumatic cerebral venous sinus thrombosis: a United Kingdom and Ireland survey on practice variation","volume":"5","author":"Momin SMB","year":"2024","unstructured":"Momin SMB, Davies DJ, O\u2019Halloran PJ, et al. Management of traumatic cerebral venous sinus thrombosis: a United Kingdom and Ireland survey on practice variation. Neurotrauma Rep 2024; 5: 540\u2013551. https:\/\/doi.org\/10.1089\/neur.2023.0118","journal-title":"Neurotrauma Rep"},{"key":"e_1_3_4_36_2","doi-asserted-by":"publisher","DOI":"10.3171\/2020.4.JNS20511"},{"key":"e_1_3_4_37_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jocn.2022.01.027"},{"key":"e_1_3_4_38_2","doi-asserted-by":"publisher","DOI":"10.1515\/raon-2016-0026"},{"key":"e_1_3_4_39_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000006959"},{"key":"e_1_3_4_40_2","doi-asserted-by":"publisher","DOI":"10.1161\/STR.0000000000000456"},{"key":"e_1_3_4_41_2","doi-asserted-by":"publisher","DOI":"10.3171\/2016.3.PEDS15690"},{"key":"e_1_3_4_42_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.nec.2016.05.011"},{"key":"e_1_3_4_43_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00247-015-3458-x"},{"key":"e_1_3_4_44_2","first-page":"249","article-title":"Cerebral veins: comparative study of CT venography with intraarterial digital subtraction angiography","volume":"20","author":"Wetzel SG","year":"1999","unstructured":"Wetzel SG, Kirsch E, Stock KW, et al. Cerebral veins: comparative study of CT venography with intraarterial digital subtraction angiography. AJNR Am J Neuroradiol 1999; 20: 249\u2013255.","journal-title":"AJNR Am J Neuroradiol"},{"key":"e_1_3_4_45_2","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A4843"},{"key":"e_1_3_4_46_2","doi-asserted-by":"publisher","DOI":"10.1111\/ene.13381"},{"key":"e_1_3_4_47_2","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A6337"},{"key":"e_1_3_4_48_2","doi-asserted-by":"publisher","DOI":"10.3171\/2024.4.PEDS24109"},{"key":"e_1_3_4_49_2","doi-asserted-by":"publisher","DOI":"10.1148\/rg.2020190023"},{"key":"e_1_3_4_50_2","doi-asserted-by":"publisher","DOI":"10.1111\/1754-9485.12865"},{"key":"e_1_3_4_51_2","doi-asserted-by":"publisher","DOI":"10.1186\/s41983-022-00584-5"},{"key":"e_1_3_4_52_2","doi-asserted-by":"publisher","DOI":"10.1148\/rg.2018170140"},{"key":"e_1_3_4_53_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00701-021-04916-x"},{"key":"e_1_3_4_54_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2024.05.019"},{"key":"e_1_3_4_55_2","doi-asserted-by":"publisher","DOI":"10.4103\/0028-3886.170063"},{"key":"e_1_3_4_56_2","doi-asserted-by":"publisher","DOI":"10.4103\/0974-2700.173865"},{"key":"e_1_3_4_57_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jocn.2012.01.002"},{"key":"e_1_3_4_58_2","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.132.12.1300"},{"key":"e_1_3_4_59_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0036-1584197"},{"key":"e_1_3_4_60_2","doi-asserted-by":"publisher","DOI":"10.1097\/00006123-199805000-00129"},{"key":"e_1_3_4_61_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0044-1790607"},{"key":"e_1_3_4_62_2","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000002668"},{"key":"e_1_3_4_63_2","first-page":"70","article-title":"Dural sinus thrombosis following head injury: report of two cases and review of the literature","volume":"18","author":"Dalgi\u00e7 A","year":"2008","unstructured":"Dalgi\u00e7 A, Se\u00e7er M, Erg\u00fcng\u00f6r F, et al. Dural sinus thrombosis following head injury: report of two cases and review of the literature. Turk Neurosurg 2008; 18: 70\u201377.","journal-title":"Turk Neurosurg"},{"key":"e_1_3_4_64_2","doi-asserted-by":"publisher","DOI":"10.1227\/01.neu.0000489744.00212.28"},{"key":"e_1_3_4_65_2","doi-asserted-by":"publisher","DOI":"10.3171\/2009.2.JNS08491"}],"container-title":["The Neuroradiology Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/19714009261467323","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/19714009261467323","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/19714009261467323","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T11:48:48Z","timestamp":1783597728000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/19714009261467323"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,7]]},"references-count":64,"alternative-id":["10.1177\/19714009261467323"],"URL":"https:\/\/doi.org\/10.1177\/19714009261467323","relation":{},"ISSN":["1971-4009","2385-1996"],"issn-type":[{"value":"1971-4009","type":"print"},{"value":"2385-1996","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,7]]},"article-number":"19714009261467323"}}