Delayed Post-traumatic Pseudoaneurysmal Formation of the Intracranial Ophthalmic Artery After Closed Head Injury  -Case Report-

Kikkawa, Yuichiro; Natori, Yoshihiro; Sasaki, Tatsuya

doi:10.2176/nmc.52.41

Cited by 11 publications

(7 citation statements)

References 11 publications

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“… 10) In the supraclinoid segment, the carotid artery transitions from a relatively fixed structure in the skull base and cavernous sinus to a relatively mobile structure as it ascends into the cisternal spaces. Researchers believe that either movement of the supraclinoid segment against the anterior clinoid process or stretching of the carotid artery at this transition zone leads to the formation of such an aneurysm, 7 , 12 , 13) and this mechanism apparently applies to our case.…”

Section: Discussionmentioning

confidence: 56%

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Visualization of a Traumatic Pseudoaneurysm at Internal Carotid Artery Bifurcation due to Blunt Head Injury: A Case Report

Han

Koh

Choi

et al. 2014

Korean J Neurotrauma

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Traumatic intracranial pseudoaneurysms occurring after blunt head injuries are rare. We report an unusual case of subarachnoid hemorrhage (SAH) caused by rupturing of the traumatic pseudoaneurysm of the internal carotid artery (ICA) bifurcation that resulted from a non-penetrating injury. In a patient with severe headache and SAH in the right sylvian cistern, which developed within 7 days after a blunt-force head injury, a trans-femoral cerebral angiogram (TFCA) showed aneurysmal sac which was insufficient to confirm the pseudoaneurysm. We obtained a multi-slab image of three dimensional time of flight (TOF) of magnetic resonance angiography (MRA). The source image of the gadolinium-enhanced MRA revealed an intimal flap within the intracranial ICA bifurcation, providing a clue for the diagnosis of a dissecting pseudoaneurysm at the ICA bifurcation due to blunt head trauma. We performed direct aneurysmal neck clipping, without neurological deficit. A follow-up TFCA did not show either aneurysm sac or luminal narrowing. We suggest that in the patient with a history of blunt head injury with SAH following shortly, multi-slab image of 3D TOF MRA can give visualization of the presence of a pseudoaneurysm.

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Section: Discussionmentioning

confidence: 56%

“…Traumatic pseudoaneurysm occasionally regresses in size or spontaneously disappear, 7 , 9 , 11) but they also have a high incidence of rupturing. Therefore, surgery or endovascular treatment is necessary as soon as possible.…”

Section: Discussionmentioning

confidence: 99%

Visualization of a Traumatic Pseudoaneurysm at Internal Carotid Artery Bifurcation due to Blunt Head Injury: A Case Report

Han

Koh

Choi

et al. 2014

Korean J Neurotrauma

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“…1) However, there are reports of rare origins, such as the basilar and middle meningeal arteries. 4,5) A review of the literature revealed only six reported cases of traumatic pseudoaneurysm of the OphA and its tributaries (Table 1), 2,3,[6][7][8][9] only two of which had epistaxis. 2,3) In one case, a gunshot wound had injured the cranial base and the OphA.…”

Section: Discussionmentioning

confidence: 99%

Traumatic Anterior Ethmoidal Artery Pseudoaneurysm with Repeated Epistaxis Treated by Transarterial Embolization: A Case Report

Kuranari

Akiyama

Yanagisawa

et al. 2019

JNET

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Pseudoaneurysms of the internal carotid artery (ICA) and sphenopalatine artery (SPA) are recognized as sources of arterial epistaxis following head and face trauma. However, epistaxis involving pseudoaneurysm of the anterior ethmoidal artery (AEA) is extremely rare. Case Presentation: A 25-year-old man experienced massive epistaxis due to a ruptured traumatic pseudoaneurysm of the AEA. The patient had suffered head and face trauma in a car accident. CT showed fractures of the frontal, ethmoidal, and maxillary bones, and he was managed conservatively. Nine days after the injury, he had sudden, massive epistaxis. Angiography showed a right AEA aneurysm, which was treated successfully with transarterial embolization using n-butyl-2-cyanoacrylate (NBCA). Conclusion: Although pseudoaneurysm of the AEA is a rare cause of epistaxis, it is important to consider this diagnosis, in addition to pseudoaneurysm of the SPA and ICA, when a patient has massive arterial epistaxis following a traumatic skull base fracture, especially if the fracture is adjacent to the ethmoid sinus. Transarterial embolization using glue is a feasible therapeutic option for this condition.

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“…It occurs most commonly in the peripheral arteries or the internal carotid artery (ICA) in a closed head injury. 3 5 9 10 11 14) Traumatic ophthalmic artery aneurysms are particularly rare. We present a case of endovascular treatment of traumatic ophthalmic artery aneurysm which had grown late after closed head injury.…”

Section: Introductionmentioning

confidence: 99%

Coil Embolization of Traumatic Ophthalmic Artery Aneurysm: Case Report

Shim

2022

Korean J Neurotrauma

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We describe the case of a 57-year-old man who had traumatic subarachnoid hemorrhage (SAH) with a delayed growth of an ophthalmic artery aneurysm. Initially, computed tomography angiography did not show any evidence of aneurysmal dilatation, but digital subtraction angiography (DSA) after 3 days showed small aneurysmal dilatation or dissection of a presumed lesion. Early intervention or surgery was difficult because of the patient's unstable condition. The SAH was completely resolved within 7 days. Follow-up DSA was performed 2 weeks later and it revealed an increasing size and shape change. We treated the patient with coil embolization, partially filling the aneurysm to save the ophthalmic artery. DSA performed 6 months later indicated that the aneurysm was completely embolized, sparing the ophthalmic artery. In traumatic SAH, delayed growth of the aneurysm should always be considered, and follow-up imaging should be performed. Partial embolization to save the ophthalmic artery can be one of the treatment modalities for selected patients.

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Delayed Post-traumatic Pseudoaneurysmal Formation of the Intracranial Ophthalmic Artery After Closed Head Injury -Case Report-

Cited by 11 publications

References 11 publications

Visualization of a Traumatic Pseudoaneurysm at Internal Carotid Artery Bifurcation due to Blunt Head Injury: A Case Report

Visualization of a Traumatic Pseudoaneurysm at Internal Carotid Artery Bifurcation due to Blunt Head Injury: A Case Report

Traumatic Anterior Ethmoidal Artery Pseudoaneurysm with Repeated Epistaxis Treated by Transarterial Embolization: A Case Report

Coil Embolization of Traumatic Ophthalmic Artery Aneurysm: Case Report

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