Traumatic Anterior Cerebral Artery Aneurysm following Blunt Craniofacial Trauma

Abstract

Background: Traumatic aneurysms of the anterior cerebral artery (ACA) were retrospectively reviewed in an effort to identify patients at high risk of ACA aneurysm. Methods: Blunt craniofacial trauma patients featuring vascular injuries over the region of the ACA were studied. Results: Six patients featuring eight ACA aneurysms were diagnosed between June 1992 and December 2005, inclusively. Seven aneurysms were located at nonbranched sites and one was located over the right ACA-anterior communicating artery junction. One patient died immediately of massive intracranial lobar hemorrhage (ICH). The other 5 patients experienced rebleeding during a period of from 1 to 29 days. Brain computed tomography revealed subarachnoid hemorrhage (SAH) in 1 of these 6 patients, ICH over the medial frontal area or cingulated gyrus in 4 patients, intraventricular hemorrhage (IVH) in 3 patients, and an interhemispheric subdural hematoma (SDH) in 2 patients. Conclusion: Delayed-onset deterioration of neurological deficit is the most common clinical presentation of traumatic ACA aneurysms. Midline hemorrhage such as medial frontal hemorrhage or cingulate gyrus hemorrhage, and the presence of an interhemispheric SDH associated with SAH and IVH subsequent to blunt craniofacial trauma should be further evaluated, as they pre-sent a high risk of traumatic ACA aneurysms to patients.

Hemorrhagic Progression of a Contusion after Traumatic Brain Injury: A Review

“…Unfortunately, there is ambiguity in the literature. ''Delayed intracerebral hematoma'' or DTICH may refer to cases that present many weeks after injury, when delayed hemorrhage may be due to a traumatic intracranial aneurysm (Horiuchi et al, 2007;Hossain et al, 2002;Kaplan et al, 2003;McFeeley et al, 1988;Yang et al, 2007). The term ''progressive hemorrhagic injury'' has been used to refer to progression of an epidural hematoma, subdural hematoma, intraparenchymal contusion or hematoma, or subarachnoid hemorrhage (Oertel et al, 2002).…”

Traumatic Aneurysm of the Callosomarginal Artery-Cortical Artery Junction from Penetrating Injury by Scissors

“…TICAs are often fragile and prone to rupture, and therefore present a challenging subset of vascular lesions for either surgical or endovascular therapy23). In our patient, neck clipping was difficult because the aneurysm had no defined aneurysmal neck.…”

Traumatic anterior communicating artery pseudoaneurysm with cavernous sinus fistula

“…Traumatic pseudoaneurysms tend to occur on the distal ACA, distal middle cerebral artery, or intracavernous internal carotid artery (ICA), secondary to an impact against the falcine or bony edge [1,2,5,10]. In contrast, traumatic aneurysms seldom occur on the A1 portion or AcoA [6,13]. The mechanism leading to traumatic aneurysms of the A1 portion or AcoA may be associated with fractures of the skull base [6].…”

“…The mechanism leading to traumatic aneurysms of the A1 portion or AcoA may be associated with fractures of the skull base [6]. Yang et al reviewed eight ACA aneurysms following blunt craniofacial trauma [13]. Only one of eight ACA aneurysms was located over the ACA-AcoA junction [13].…”

“…An intracranial traumatic pseudoaneurysm of the anterior communicating artery (AcoA) is a rare complication of head injury [6,13]. The formation of a fistula between a traumatic pseudoaneurysm of the AcoA and the cavernous sinus has not been reported previously.…”