High-voltage electrical burn of the skull causing thrombosis of the superior sagittal sinus

We aimed to describe the effects of high-voltage electricity on the scalp, meninges, brain parenchyma, and venous sinuses of a 10-year-old girl with an accidental high-voltage electrical burn of the head who presented with an area of full-thickness scalp loss. Magnetic resonance venography demonstrated that the anterior third of the superior sagittal sinus was thrombosed. The child underwent surgical debridement of the wound with a duraplasty and transposition scalp-flap reconstruction. She recovered well after surgery. Our patient had no neurological deficit at presentation, and she had no new deficit at her 6-month follow-up examination. We concluded that despite the electrical nature of the brain, direct neural injury is largely thermal. To our knowledge, a scalp burn deep enough to involve the superior sagittal sinus has not been reported. Physicians must be aware of the potential for delayed neurological deterioration, including severe deficits such as quadriplegia. (C) 2011 Elsevier Ltd. All rights reserved.