Traumatic aneurysms of cerebral arteries a study of five cases

Abstract

Five cases of traumatic aneurysms of cerebral arteries are presented, two located at the internal carotid artery, and three at peripheral arterial branches. The manifestation of the aneurysm was a delayed neurological deterioration due to bleeding from the aneurysm, 4-35 days (mean 21 days) after the head trauma; four patients had an intracerebral haematoma and one patient had a subarachnoid haemorrhage. One patient died from extensive cerebral injuries with the aneurysm untreated. In four cases the aneurysm was treated surgically. Three patients returned to their former occupation and one patient died from late septic complications. It is concluded that signs of delayed intracranial bleeding after a head trauma should raise the suspicion of an underlying traumatic aneurysm, and in addition to a CT-scan an angiography should be performed.

Traumatic aneurysm of the supraclinoid internal carotid artery and an associated carotid—cavernous fistula: vascular reconstruction performed using intravascular implantation of stents and coils

“…Direct surgery on these aneurysms is very difficult and risky because of their fragile, broad, and obscure necks. 1,2,5,8,16,27 In our case, an EC-IC bypass was required because an insufficiency of the collateral blood supply was expected, due to severe narrowing of the supraclinoid segment of the ICA and occlusion of the A 1 segment of the right ACA. Both were possibly due to dissection, preventing collateral flow through the posterior communicating artery and the anterior communicating artery, respectively.…”

“…2,4,12,27,29,[32][33][34]38 Rupture usually occurs within 2 or 3 weeks after trauma, and a high mortality rate has been associated with these cases. 1,4,5,8,16,34 In particular, traumatic aneurysms of the supraclinoid ICA appear to follow a poor natural course, with high mortality and morbidity rates. 2,4,8,27,29,[32][33][34] In our case, the diagnosis of traumatic aneurysm was made 11 days after trauma, which prompted us to treat this lesion as soon as possible.…”

Traumatic intracranial aneurysm in blunt trauma

“…However, this rate is based on the number of aneurysms identified and not based on the incidence of the patients with blunt TBI. Jakobsson et al [7] reports only five cases of TICA detected among blunt TBI cases in a 14-year retrospective cohort. Nakstad et al [8], in a study published in 1986, reported three cases of TICA after blunt TBI among 912 operated patients for intracerebral aneurysm; in a time span of more than 12 years.…”

Zur Ph�nomenologie und Morphologie spontaner t�dlicher Hirnaneurysmablutungen

“…Die Zusammenh~inge zwischen fiul3erer Gewalteinwirkung und Aneurysmablutung bereiten wie bereits eingangs erw~ihnt, gutachterlich die gr613ten Schwierigkeiten [5,10,12,17,24,37,40,43,45,47,48,55,56,58,61,67,70,71,79,83,116,123], wobei einerseits die Frage zu prfifen ist, ob ein vorbestehendes Aneurysma aufgrund der Gewalteinwirkung vorzeitig rupturiert ist oder ob eine allein traumatisch bedingte Geffif3ruptur (ohne Aneurysma) vorlag. Auch ein schon lfingere Zeit zurfickliegendes Schfidel-Hirntrauma kann gelegentlich zu einer Geffil3verletzung mit Ausbildung eines ,,Pseudoaneurysmas" ffihren, das erst zu einem sp~iteren Zeitpunkt rupturiert.…”