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Delayed traumatic cerebral aneurysm after brain injury
D O'Brien1, M W O'Dell, A Eversol
1Department of Physical Medicine and Rehabilitation, University of Cincinnati College of Medicine, OH, USA.
Archives of Physical Medicine and Rehabilitation
|August 1, 1997
Summary
Delayed traumatic aneurysms (TAs) after traumatic brain injury (TBI) can cause late neurological issues. Early diagnosis and treatment of these rare but serious TAs are crucial for better patient outcomes.
Area of Science:
- Neurology
- Neurosurgery
- Trauma Surgery
Background:
- Traumatic aneurysms (TAs) are rare, accounting for less than 1% of all cerebral aneurysms.
- They typically present acutely after head trauma but can manifest later, causing delayed neurological deterioration.
- TAs are associated with penetrating injuries and skull base or anterior cranial fossa fractures.
Observation:
- This case report details a delayed TA presenting 46 days post-motor vehicle accident in a patient undergoing rehabilitation.
- The patient exhibited seizure, lethargy, and hemiparesis.
- Neuroimaging identified a ruptured left pericallosal artery TA.
Findings:
- The ruptured TA was successfully treated with surgical clipping.
- Delayed TAs are associated with higher mortality, particularly if ruptured.
- TAs in TBI patients are often linked to penetrating injuries and skull base fractures.
Implications:
- Clinicians must maintain vigilance for delayed TAs in at-risk TBI patients.
- Early recognition and intervention for TAs can improve prognosis.
- This case underscores the importance of considering TAs in unexplained late neurological decline after TBI.