Traumatic anterior cerebral artery aneurysm following blunt craniofacial trauma.
BACKGROUND
Traumatic aneurysms of the anterior cerebral artery (ACA) were retrospectively reviewed in an effort to identify patients at high risk of ACA aneurysm.


METHODS
Blunt craniofacial trauma patients featuring vascular injuries over the region of the ACA were studied.


RESULTS
Six patients featuring eight ACA aneurysms were diagnosed between June 1992 and December 2005, inclusively. Seven aneurysms were located at nonbranched sites and one was located over the right ACA-anterior communicating artery junction. One patient died immediately of massive intracranial lobar hemorrhage (ICH). The other 5 patients experienced rebleeding during a period of from 1 to 29 days. Brain computed tomography revealed subarachnoid hemorrhage (SAH) in 1 of these 6 patients, ICH over the medial frontal area or cingulated gyrus in 4 patients, intraventricular hemorrhage (IVH) in 3 patients, and an interhemispheric subdural hematoma (SDH) in 2 patients.


CONCLUSIONS
Delayed-onset deterioration of neurological deficit is the most common clinical presentation of traumatic ACA aneurysms. Midline hemorrhage such as medial frontal hemorrhage or cingulate gyrus hemorrhage, and the presence of an interhemispheric SDH associated with SAH and IVH subsequent to blunt craniofacial trauma should be further evaluated, as they pre-sent a high risk of traumatic ACA aneurysms to patients.
Yang
Tao-Chieh
TC
Department of Neurosurgery, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan, ROC.
Lo
Yang-Lan
YL
Huang
Yin-Chen
YC
Yang
Shun-Tai
ST
D000293:Adolescent; D000328:Adult; D000368:Aged; D002533:Cerebral Angiography / Q000379:methods; D002536:Cerebral Arteries / Q000293:injuries* / Q000473:pathology; D002675:Child, Preschool; D016489:Head Injuries, Closed / Q000150:complications*; D006801:Humans; D002532:Intracranial Aneurysm / Q000209:etiology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed