Depressed Skull Fractures Overlying Dural Venous Sinuses: Management Strategies and Outcomes

Background:Depressed skull fractures involving the dural venous sinuses represent a complex neurosurgical emergency. These fractures carry a significant risk of complications such as venous sinus thrombosis, intracranial haemorrhage, and neurological deterioration.Objective:To compare the clinical outcomes of surgical versus conservative management in patients with depressed skull fractures overlying the cerebral venous sinuses.Methods:forty patients with depressed skull fractures involving dural venous sinuses were enrolled. Patients were treated either surgically or conservatively. All patients underwent thorough clinical evaluation, neuroimaging, and laboratory investigations, with follow-up extending up to 6 months to assess neurological recovery and complications.Results:twenty tow (55%) underwent surgical intervention, while 18 (45%) were managed conservatively. The mean hospital stay was 4.88 ± 1.73 days, and the average follow-up period was 6.98 ± 2.98 months. Overall, 80% of patients achieved good recovery, while 20% experienced mild disability. Surgical management was significantly associated with a higher incidence of mild disability (p = 0.005). Conclusion:Both surgical and conservative management can be effective in treating depressed skull fractures involving dural venous sinuses. However, conservative treatment may be associated with better outcomes in selected patients without neurological deficits or extensive fracture involvement.