Traumatic aneurysms of cerebral arteries. A study of five cases

Five cases of traumatic aneurysms of cerebral arteries are presented, two located at the internal carotid artery, and three at peripheral arterial branches. The manifestation of the aneurysm was a delayed neurological deterioration due to bleeding from the aneurysm, 4-35 days (mean 21 days) after the head trauma; four patients had an intracerebral haematoma and one patient had a subarachnoid haemorrhage. One patient died from extensive cerebral injuries with the aneurysm untreated. In four cases the aneurysm was treated surgically. Three patients returned to their former occupation and one patient died from late septic complications. It is concluded that signs of delayed intracranial bleeding after a head trauma should raise the suspicion of an underlying traumatic aneurysm, and in addition to a CT-scan an angiography should be performed.