Visualization of a Traumatic Pseudoaneurysm at Internal Carotid Artery Bifurcation due to Blunt Head Injury: A Case Report.
10.13004/kjnt.2014.10.2.126
- Author:
Ju Hee HAN
1
;
Eun Jeong KOH
;
Ha Young CHOI
;
Jung Soo PARK
;
Jong Myong LEE
Author Information
1. Department of Neurosurgery, Chonbuk National University Medical School-Hospital, Jeonju, Korea. kohejns@jbnu.ac.kr
- Publication Type:Case Report
- Keywords:
Head injuries closed;
Carotid artery injuries;
Magnetic resonance angiography;
Aneurysm false
- MeSH:
Aneurysm;
Aneurysm, False*;
Carotid Artery Injuries;
Carotid Artery, Internal*;
Craniocerebral Trauma;
Diagnosis;
Follow-Up Studies;
Head Injuries, Closed*;
Headache;
Humans;
Magnetic Resonance Angiography;
Neck;
Phenobarbital;
Subarachnoid Hemorrhage
- From:Korean Journal of Neurotrauma
2014;10(2):126-129
- CountryRepublic of Korea
- Language:English
-
Abstract:
Traumatic intracranial pseudoaneurysms occurring after blunt head injuries are rare. We report an unusual case of subarachnoid hemorrhage (SAH) caused by rupturing of the traumatic pseudoaneurysm of the internal carotid artery (ICA) bifurcation that resulted from a non-penetrating injury. In a patient with severe headache and SAH in the right sylvian cistern, which developed within 7 days after a blunt-force head injury, a trans-femoral cerebral angiogram (TFCA) showed aneurysmal sac which was insufficient to confirm the pseudoaneurysm. We obtained a multi-slab image of three dimensional time of flight (TOF) of magnetic resonance angiography (MRA). The source image of the gadolinium-enhanced MRA revealed an intimal flap within the intracranial ICA bifurcation, providing a clue for the diagnosis of a dissecting pseudoaneurysm at the ICA bifurcation due to blunt head trauma. We performed direct aneurysmal neck clipping, without neurological deficit. A follow-up TFCA did not show either aneurysm sac or luminal narrowing. We suggest that in the patient with a history of blunt head injury with SAH following shortly, multi-slab image of 3D TOF MRA can give visualization of the presence of a pseudoaneurysm.
