title: Traumatic anterior cerebral artery aneurysm following blunt craniofacial trauma.
abstract: 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.
authors.affiliation: Department of Neurosurgery, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan, ROC.
authors.forename: Tao-Chieh
authors.initials: TC
authors.lastname: Yang
authors.forename: Yang-Lan
authors.initials: YL
authors.lastname: Lo
authors.forename: Yin-Chen
authors.initials: YC
authors.lastname: Huang
authors.forename: Shun-Tai
authors.initials: ST
authors.lastname: Yang
mesh_terms: 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