A 6-year-old boy was found by his parents with his neck trapped under an automatically controlled garage door. Cardiopulmonary resuscitation was immediately instituted by the parents. After stabilization and ventilatory assistance, the patient was transferred to Children's Hospital of Wisconsin in Milwaukee. At the time of admission, the patient was comatose with fixed and dilated pupils. Numerous contusions and petechiae were noted over his cheeks and orbits. Cranial computed tomography was performed both with and without intravenous contrast medium enhancement (Figs 1 and 2).
Denouement and Discussion
Poststrangulation Cerebral Sinovenous Thrombosis
Cerebral sinovenous thrombosis has been classified as being either septic or aseptic. Septic thrombosis is secondary to inflammation involving the intracranial venous system, as in meningitis and encephalitis, or from intracranial spread from mastoiditis or sinusitis. Aseptic causes are many (eg, polycythemia vera, trauma, strangulation, dehydration, congenital heart disease, collagen vascular disease, and oral contraceptive use), and rarely does this condition occur as an isolated
Schroeder BA, Czarnecki DJ, Wells RG, Sty JR, Young LW, Wood BP. Radiological Case of the Month. Am J Dis Child. 1988;142(11):1235–1236. doi:10.1001/archpedi.1988.02150110113033