Angiographic aspects of traumatic intracranial aneurysms following war injuries

Intracranial aneurysms following head injuries occur very rarely. Only 15 cases following injuries by missiles or shrapnel have been reported in the world literature. The angiographic findings in seven cases injured during the recent fighting in Lebanon, are described. The relatively high frequency of occurrence of these aneurysms in our cases might be explained by the fact that they were injured by low velocity missiles. A high velocity missile would disrupt an artery completely. It is also of interest that most of the aneurysms originated from arterial branches along the path of the foreign body, but not in contact with it. Unlike congenital aneurysms, they bore no relationship to arterial bifurcations and, unlike aneurysms following closed-head injuries, none involved the large basal arteries. None of them had a neck, and a mass effect due to bleeding was found in six of the cases.