J Korean Soc Emerg Med.  2007 Dec;18(6):609-614.

The Diagnostic Method and Importance of Intracranial Pseudoaneurysm Developed by Head trauma: Case report

• Bang JS
• Kim MC

Abstract

Traumatic intracranial pseudoaneurysms are rare and it is easy to overlook the evaluation of intracranial vascular injury in head trauma patients in the emergency room. If the result of missing an intracranial aneurysm however is catastrophic. I describe a case of a patient with intracranial internal carotid artery (ICA) pseudoaneurysm after head trauma and stress the importance of obtaining a three-dimensional-computed tomogram angiography (3DCTA) in cases of patients with skull base fracture or eyeball pain. We report a case which a patient complained of severe headache and right eyeball pain after head trauma. 3D-CTA revealed carotid-cavernous fistula and pseudoaneurysm of the right ICA. After performing transfemoral carotid angiography (TFCA) and a balloon occlusion test, we carried out endovascular trapping of ICA and extracranial-intracranial (EC-IC) bypass surgery. Afterward, the patient was discharged without neurological deficit after two weeks. We recommended 3D-CTA in cases of head trauma when the patient has skull base fracture or sphenoid sinus fracture.

Keyword

Head Trauma; Pseudoaneurysm; 3D-CTA

MeSH Terms

Aneurysm, False*
Angiography
Balloon Occlusion
Carotid Artery, Internal
Craniocerebral Trauma*
Emergency Service, Hospital
Fistula
Head*
Headache
Humans
Intracranial Aneurysm
Skull Base
Sphenoid Sinus
Vascular System Injuries