Catastrophic delayed rupture of a traumatic aneurysm of the distal superior cerebellar artery in a child

Fatal Traumatic Subarachnoid Hemorrhage due to Acute Rebleeding of a Pseudoaneurysm Arising from the Distal Basilar Artery

“…For penetrating injury, the mechanism of traumatic aneurysms is direct injury from the bone fragments of skull fractures; in blunt injury, the mechanism is overstretching, torsion, or compression against the dura or bony prominences 2 , 5 , 8) . Traumatic aneurysms of the basilar artery are almost associated with basal skull fractures 6) , and the arterial wall can be lacerated by a fractured clivus or tentorium secondary to rapid deceleration 3 , 7 , 9) . Traumatic intracranial aneurysms usually become symptomatic after a symptom-free interval following the traumatic episode.…”

“…The several reported treatment options include surgical repair and endovascular embolization 4 , 6) . An examination of the recent literature suggests that endovascular treatment has become preferable to surgical repair, and the preference for this treatment option is likely due to traumatic pseudoaneurysms having friable walls and poorly defined neck 2 , 5 , 6 , 7 , 8 , 9) . In our case, endovascular coil embolization was used for the management of the pseudoaneurysm in consideration of the patient's poor clinical condition and the deep location of the pseudoaneurysm.…”

Head Trauma and Distal Anterior Cerebral Artery Aneurysm: Potential Role of an Adhesion to the Falx

“…Either way, this case illustrates the need for a high degree of suspicion in the presence of posttraumatic intracranial hemorrhage, especially when its location is atypical. For traumatic dACA aneurysms, close follow-up and repeat imaging are necessary, because they tend to evolve and secondarily rupture, often with dire consequences, 9,[11][12][13][14] and, in one early review, almost half of the reported traumatic intracranial aneurysms presented only with delayed subarachnoid hemorrhage. 3 Although spontaneous healing of traumatic aneurysms has been reported, 10,15 it is uncommon, and in the absence of aneurysm exclusion, mortality is high, approaching 50%.…”

“…1,7,8,16,17 Similarly, traumatic aneurysms have been described at the superior cerebellar artery (SCA), which runs close to the free edge of the tentorium. 14,18,19 Drake already suggested that adhesions between arteries and the dura mater may be responsible for arterial "rents," damage to the arterial wall, and bleeding, due to the abrupt movement of the vessel fixed at a specific point. 20 The hypothesis of injury of a mobile vessel close to a fixed dural structure has since then been commonly brought up in the literature.…”

Operative open intra-aneurysmal thrombectomy for ruptured cerebral aneurysm and peripheral ischemia associated with vasospasm

“…These aneurysms consist of a cavity of fragile encapsulated haematoma, communicating with the arterial lumen. 10 Endovascular embolisation, with detachable coils or liquid embolic agents, is an effective alterna-tive, which also allows assessment of the collateral circulation at the time of treatment. Traumatic pseudoaneurysms arising from distal SCA are therefore generally treated with parent artery occlusion.…”