# Skip Island Craniotomy: A Technique for Managing Superior Sagittal Sinus Injury in Emergency Neurosurgery

## TL;DR

This paper introduces a new neurosurgical technique called 'skip island craniotomy' to manage injuries to the superior sagittal sinus in emergency situations.

## Contribution

The novel 'skip island craniotomy' technique is introduced for managing superior sagittal sinus injuries in trauma patients.

## Key findings

- Two patients with superior sagittal sinus injuries were successfully treated using the skip island craniotomy technique.
- Postoperative imaging confirmed the island-like pattern with burr holes, and patients had no neurological deficits.
- The technique allowed for effective management with good cosmetic outcomes and short ICU stays.

## Abstract

Superior sagittal sinus (SSS) injury can be a life-threatening condition. It is rarely injured by means of penetrating and nonpenetrating traumatic brain injury (TBI). Injury to the SSS can be a surgical challenge and thus provides a conundrum to neurosurgeons on its management in an acute emergency setting.

We present a series of two cases that were successfully treated by a novel skip island craniotomy technique after suffering a penetrating and nonpenetrating TBI-related SSS injury, respectively.

Both patients had a short period of ITU stay before being managed on the neurosurgery ward and went on to have no neurological deficits. The operative wounds healed well, and overall cosmesis was unaffected. Postoperative computed tomography head scans with 3D reconstruction in bone window demonstrate the island-like pattern with interval burr holes.