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Traumatic brachiocephalic pseudoaneurysm presenting with delayed stroke: case report.

A Sommer1, S Meairs, F Gueckel

  • 1Department of Radiology, University Hospital Mannheim, Medical Faculty of University Heidelberg, Germany.

Neuroradiology
|December 8, 2000
PubMed
Summary
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A young man experienced recurrent strokes due to traumatic pseudoaneurysms in the carotid and subclavian arteries, likely caused by a past car accident. This case highlights a rare cause of stroke in young adults from seat-belt trauma.

Area of Science:

  • Vascular Surgery
  • Neurology
  • Trauma Medicine

Background:

  • Traumatic pseudoaneurysms are rare vascular injuries.
  • Recurrent strokes in young adults warrant investigation into underlying causes.

Observation:

  • A 19-year-old male presented with acute left hemiparesis and a history of stroke-like episodes.
  • Imaging revealed pseudoaneurysms of the internal carotid artery bifurcation and subclavian artery.
  • A significant car accident 3 years prior was noted in his medical history.

Findings:

  • Contrast-enhanced MR angiography and Doppler sonography confirmed the presence of carotid and subclavian artery pseudoaneurysms.
  • The pseudoaneurysms were presumed to be a result of seat-belt trauma from the previous accident.
  • Thrombus within the pseudoaneurysms was identified as the likely source of artery-to-artery embolism, causing recurrent strokes.

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Implications:

  • This case underscores the potential for delayed vascular complications from trauma, even in young individuals.
  • It emphasizes the importance of considering traumatic vascular injury in the differential diagnosis of stroke in young patients.
  • Early diagnosis and management of traumatic pseudoaneurysms are crucial to prevent further embolic events and neurological deficits.