Traumatic aneurysms of the pericallosal arteries

Nakstad, P; Nornes, Helge; Hauge, Hilde

doi:10.1007/bf00333440

Cited by 79 publications

(29 citation statements)

References 10 publications

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“…Young individuals seem to be especially at risk of developing traumatic aneurysms and it seems appropriate to draw special attention to children with massive SAH and hematomas around the anterior cerebral falx. When the brain is dislocated laterally crossing the midline and anterior falx the anterior cerebral arteries are at risk of wall damage and aneurysm development 2,6 . Even newborns may develop an aneurysm following traumatic births 16 .…”

Section: Discussionmentioning

confidence: 99%

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Correlation of Head Trauma and Traumatic Aneurysms

2008

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Subarachnoid hemorrhage following severe trauma to the head is relatively common. In most cases the bleed originates from superficial veins and occasionally from arteries. Following the replacement of cerebral angiography with CT in the diagnostic evaluation of head traumas fewer traumatic aneurysms have been observed. This may indicate that some traumatic aneurysms are missed if angiographic procedures are not performed in patients with severe head injury. Trauma patients admitted to our institution are submitted to CT including a bone algorithm. In case of subarachnoid hemorrhage, especially in the basal cisterns, CT- angiography is performed. Digital subtraction angiography is performed as well in cases with uncertain interpretations. During one year 81 patients were admitted with subarachnoid hemorrhage following head trauma. Thirteen (16%) of them underwent CT-angiography and in five (6.2%) with SAH in the basal cistern traumatic aneurysms were found. Four of these cases had a skull base fracture including fractures through the clivus. Four cases were embolized and one very small extradural aneurysm is still not treated. One small pericallosal aneurysm was operated. A traumatic aneurysm should always be suspected n patients with skull base fractures and subarachnoid hemorrhage in the basal cisterns.

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Section: Discussionmentioning

confidence: 99%

“…However, a bleeding in the basal cistern should in any case be subject to further neuroradiological examination to find the source of bleeding 5,6 . The aim of this paper is to describe the diagnostic and therapeutic aspects in patients with skull base fractures and traumatic cerebral aneurysms.…”

Section: Introductionmentioning

confidence: 99%

Correlation of Head Trauma and Traumatic Aneurysms

2008

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“…3,8,13,21,24,28 Although several small studies within the civilian sector exist concerning these entities, it has been through large-scale military conflict that advances in diagnosis, natural history, and treatment have occurred. 1,2,4,10,17 Groundbreaking work in the area of traumatic aneurysms was first reported in 1988 following the Iran-Iraq War.…”

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confidence: 99%

The evolution of the treatment of traumatic cerebrovascular injury during wartime

Bell

Ecker

Severson³

et al. 2010

FOC

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The approach to traumatic craniocervical vascular injury has evolved significantly in recent years. Conflicts prior to Operations Iraqi and Enduring Freedom were characterized by minimal intervention in the setting of severe penetrating head injury, in large part due to limited far-forward resource availability. Consequently, sequelae of penetrating head injury like traumatic aneurysm formation remained poorly characterized with a paucity of pathophysiological descriptions. The current conflicts have seen dramatic improvements with respect to the management of severe penetrating and closed head injuries. As a result of the rapid field resuscitation and early cranial decompression, patients are surviving longer, which has led to diagnosis and treatment of entities that had previously gone undiagnosed. Therefore, in this paper the authors' purpose is to review their experience with severe traumatic brain injury complicated by injury to the craniocervical vasculature. Historical approaches will be reviewed, and the importance of modern endovascular techniques will be emphasized.

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“…False negative angiography may also result from vasospasm due to subarachnoid hemorrhage, compression of the aneurysm by a surrounding hematoma, and thrombotic occlusion of the aneurysm. 7,52,61) Traumatic intracranial aneurysm is associated with high morbidity and mortality, so early detection and treatment are important. Traumatic aneurysm should be suspected if fracture of the sphenoid sinus and/or carotid canal is observed, especially accompanied by epistaxis; if delayed subarachnoid hemorrhage, unexplained neurological deterioration, or progressive cranial nerve paresis is observed; if a juxtafalcine hematoma is observed; or if the trauma is a penetrating injury, especially resulting from a stab wound or gunshot wound.…”

Section: Discussionmentioning

confidence: 99%

“…The diagnosis of acute head trauma is now usually based on computed tomography (CT), and less frequently on cerebral angiography, 52,55) so that traumatic vascular lesions, including traumatic aneurysms and arteriovenous fistulas, may be overlooked. Traumatic intracranial aneurysm is a wellknown cause of``delayed'' apoplexy in patients with severe head trauma.…”

Section: Introductionmentioning

confidence: 99%

"Early" Apoplexy Due to Traumatic Intracranial Aneurysm. Case Report.

Komiyama

Morikawa

Nakajima

et al. 2001

Neurol. Med. Chir.(Tokyo)

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A 76-year-old man presented with a traumatic aneurysm of the left internal carotid artery which caused repeated subarachnoid hemorrhages within 20 hours of a fall from a height. Early computed tomography (CT) detected no brain abnormalities, but repeat CT found subarachnoid hemorrhage. Internal carotid angiography detected a pseudoaneurysm, which was not treated because of his poor clinical condition. He died of multiple organ failure. Early detection of a traumatic intracranial aneurysm is important for the prevention of aneurysmal rupture, or``delayed'' apoplexy. Review of 171 cases with traumatic aneurysms from the literature found that false negative angiography occurred only in three cases on post-trauma day 7 and thereafter. Early diagnostic angiography within a week of the initial trauma is indicated if traumatic aneurysm is suspected to detect early signs of irregularity, spasm, and narrowing of the arterial wall. Repeat angiography is indicated if aneurysmal formation is still highly suspected in spite of negative initial angiography.

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Traumatic aneurysms of the pericallosal arteries

Cited by 79 publications

References 10 publications

Correlation of Head Trauma and Traumatic Aneurysms

Correlation of Head Trauma and Traumatic Aneurysms

The evolution of the treatment of traumatic cerebrovascular injury during wartime

"Early" Apoplexy Due to Traumatic Intracranial Aneurysm. Case Report.

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