Traumatic intracranial aneurysms following penetrating stab wounds to the head: two unusual cases and review of the literature.
Two patients with rare complications of traumatic intracranial aneurysms following penetrating cranial stab wounds are described. One patient had a good outcome despite a secondary rupture of a traumatic proximal middle cerebral artery aneurysm, while the second patient had a traumatic basilar bifurcation artery aneurysm. To our knowledge neither the survival from a secondary rupture of a traumatic intracranial aneurysm, nor the development of a basilar bifurcation aneurysm secondary to a transcranial stab wound has been described previously. Furthermore, this is the first report of the technique of deep hypothermic cardiac arrest utilized to treat a traumatic false aneurysm. Traumatic intracranial aneurysms are a rare clinical entity, most often diagnosed after rupture and often resulting in fatal haemorrhage. A high index of suspicion needs to be maintained when managing patients with transcranial stab wounds. Early surgical intervention improves outcome by preventing initial aneurysmal rupture or rebleeding.
Nathoo
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Department of Neurosurgery, Wentworth Hospital, Durban, South Africa. Nathoo@wwh.und.ac.za
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D000328:Adult; D017542:Aneurysm, Ruptured / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D015901:Angiography, Digital Subtraction; D020197:Head Injuries, Penetrating / Q000150:complications*; D006324:Heart Arrest, Induced; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D008297:Male; D014057:Tomography, X-Ray Computed; D014951:Wounds, Stab / Q000150:complications*