Ces radiol. 2017, 71(1):41-46 | DOI: 10.55095/CesRadiol2017/003

Traumatic aneurysms of middle cerebral artery after a penetrating craniocerebral traumaCase report

Milan Liška¹, Ivan Vulev², Zuzana Lišková³, Ján Kozák¹, Andrej Šteňo¹, Juraj Šteňo¹

¹ Neurochirurgická klinika LF UK a UNB, Bratislava, Slovensko

² Klinika diagnostickej a intervenčnej radiológie, Národný ústav srdcových a cievnych chorôb, a.s., Bratislava, Slovensko

³ Radiológia s.r.o., CT a MR pracovisko, Nemocnica sv. Cyrila a Metoda, Bratislava, Slovensko

Traumatic aneurysms of cerebral arteries (TCA) are rare and therefore their pathophysiology and morfology is not so thoroughly known. The goal of this paper is to present a case report of a TCA after a penetrating craniocerebral trauma in a 17-years old adolescent. The patient was admitted to hospital after a stab injury with an iron pole. Initial CT of the head showed an intracerebral hematoma, traumatic subarachnoidal hemorrhage and intraventricular hematoma, without hydrocephalus. Patients clinical status was improving on conservative therapy, however on 18th day following trauma a sudden clinical deterioration occured. Control CT scan showed rebleeding and CT angiography showed two aneurysms of the left middle cerebral artery, that were according to localisation and history considered as traumatic. The patient underwent a successful endovascular treatment of both aneurysms and was dismissed from the hostpital with a minor neurologic deficit with a tendency to improve. Given the high risk of vascular injury after penetrating head trauma the authors suggest to perform cerebral angiography in these patients. Prove of a traumatic aneurysm may lead to prompt treatment with better prognosis.

Keywords: cerebral aneurysm, endovascular therapy, craniocerebral trauma, traumatic aneurysm

Accepted: February 27, 2017; Published: March 1, 2017  Show citation