Subdural hemorrhage in the posterior fossa caused by a ruptured cavernous carotid artery aneurysm after a balloon occlusion test. Case report.
Given the relatively benign natural history of cavernous carotid artery aneurysms and based on anecdotal reports in the literature of subarachnoid hemorrhage (SAH) or subdural hemorrhage (SDH) from these aneurysms, observation is warranted and typically recommended. In this case report, the authors describe a woman who harbored a partially thrombosed, giant cavernous aneurysm that ruptured after she underwent a balloon occlusion test (BOT) and predominately led to an SDH. The authors believe that this occurrence is the first such report in the English literature. They discuss possible mechanisms for this event and the literature related to SAH or SDH from cavernous aneurysms, including why cavernous aneurysms cause such hemorrhages. The authors also recommend that attention be paid to such lesions regarding the possibility of aneurysmal rupture following a BOT.
Andaluz
Norberto
N
The Neuroscience Institute, Department of Neurosurgery, University of Cincinnati College of Medicine, Ohio 45267-0515, USA.
Tomsick
Thomas A
TA
Keller
Jeffrey T
JT
Zuccarello
Mario
M
D000328:Adult; D017542:Aneurysm, Ruptured / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D021721:Balloon Occlusion / Q000009:adverse effects*; D002340:Carotid Artery Diseases / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D002343:Carotid Artery, Internal / Q000473:pathology; D002426:Cavernous Sinus / Q000473:pathology; D002533:Cerebral Angiography; D002544:Cerebral Infarction / Q000175:diagnosis; D004292:Dominance, Cerebral / Q000502:physiology; D004621:Embolization, Therapeutic; D005260:Female; D006408:Hematoma, Subdural / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D006801:Humans; D009886:Ophthalmoplegia / Q000209:etiology*; D010296:Parietal Lobe / Q000473:pathology; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D015899:Tomography, Emission-Computed, Single-Photon; D014057:Tomography, X-Ray Computed