Superior Sagittal Sinus Thrombosis (SSST) After Neurosurgical Procedures: A Scoping Review of Etiology, Clinical Course, Diagnosis, and Management

Background/Objectives: Postoperative superior sagittal sinus thrombosis (SSST) is an uncommon neurosurgical complication with variable clinical severity. This scoping review summarized its frequency, mechanisms, clinical presentation, management, and outcomes. Methods: MEDLINE/PubMed, Scopus, Web of Science Core Collection, and Google Scholar were searched up to 11 May 2026. Original studies reporting postoperative SSST were included and synthesized descriptively. Results: Twenty-four studies comprising 1084 patients were included, with 79 postoperative SSST cases with confirmed or extractable SSS involvement. Among studies with operative denominators, SSST frequency ranged from 0.8% to 10.0%. Reported mechanisms included local sinus injury or manipulation, cerebrospinal fluid loss or diversion, infectious/inflammatory conditions, and systemic prothrombotic factors. Clinical presentation ranged from incidental thrombosis to neurological deterioration with edema, venous infarction, or hemorrhage. Management included observation, anticoagulation, and, in selected severe cases, surgical or endovascular treatment. In small, heterogeneous cohorts with SSST-specific outcomes, mortality ranged from 0% to 33.3% and should be interpreted as a descriptive, not pooled, estimate. Conclusions: Postoperative SSST is heterogeneous in mechanism and severity. Current evidence is predominantly retrospective and case-based, limiting firm treatment recommendations.