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Updated: Jun 17, 2026
Microsurgical Clip Obliteration of Middle Cerebral Aneurysm Using Intraoperative Flow Assessment
Published on: September 25, 2009
Traumatic internal carotid artery aneurysm distant from facial bone fractures treated with a flow diverter stent: A
Tatsuya Watanabe1, Junzo Nakao1,2,3, Keishun Boku1
1Department of Emergency and Critical Care Medicine Institute of Medicine, University of Tsukuba Hospital Tsukuba Ibaraki Japan.
Background:
Traumatic intracranial aneurysms (TICAs) can be fatal if ruptured. We report a case of a TICA, distant from facial bone fractures, successfully treated with flow diverter (FD) before rupture.
Case Presentation:
A 20-year-old woman was admitted following a car accident. Initial contrast-enhanced computed tomography revealed traumatic subarachnoid hemorrhage, a 5-mm internal carotid artery aneurysm, LeFort type I + II, and mandibular fracture. On Day 8, she developed oculomotor palsy, and digital subtraction angiography revealed the aneurysm had increased to 12 mm. She started dual antiplatelet therapy (DAPT) following facial fracture repair. On Day 17, FD was placed, resulting in contrast agent stagnation within the aneurysm. Three months postinjury, her neurological symptoms improved.
Conclusion:
Screening for cerebrovascular injury is crucial several days following severe head trauma, even without skull base fractures. Unruptured TICA can be safely treated with FD following DAPT administration.
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