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Fatal traumatic vertebral artery aneurysm rupture. Case report
R L Sahjpaul1, M M Abdulhak, C G Drake
1Department of Clinical Neurological Sciences, London Health Sciences Center, Ontario, Canada.
Journal of Neurosurgery
|November 17, 1998
Summary
A rare case of head trauma caused a fatal vertebral artery berry aneurysm rupture. This is the first reported instance of posterior circulation aneurysm rupture due to head injury.
Area of Science:
- Neurology
- Trauma Surgery
- Vascular Neurosurgery
Background:
- Berry aneurysms, particularly in the posterior circulation, are a rare cause of subarachnoid hemorrhage.
- Head trauma leading to aneurysm rupture is an exceptionally uncommon event.
- Vertebral artery aneurysms are less common than internal carotid artery aneurysms.
Observation:
- A 34-year-old male sustained a fatal left vertebral artery berry aneurysm rupture after being struck by a hockey puck to the left mastoid region.
- The patient experienced immediate apnea and loss of brainstem reflexes post-injury.
- Postmortem examination revealed massive subarachnoid hemorrhage in the posterior fossa.
Findings:
- The aneurysm remnant was located near the intradural origin of the left vertebral artery, proximal to the posterior inferior cerebellar artery.
- This case represents the first documented instance of a posterior circulation aneurysm rupture directly attributed to head trauma.
- The trauma mechanism likely precipitated the aneurysm rupture, leading to catastrophic hemorrhage.
Implications:
- This case highlights the potential for severe vascular injury from seemingly isolated head trauma.
- It underscores the importance of considering vascular etiologies in patients with head trauma and sudden neurological decline.
- Further research may explore the biomechanics of traumatic aneurysm rupture in the posterior circulation.