title: Fatal traumatic aneurysm of the posterior inferior cerebellar artery with delayed rupture.
abstract: Traumatic aneurysms of intracranial arteries are rare, forming less than 1% of all intracranial arteries. They may be associated with penetrating and non-penetrating trauma. Most cases are associated with fracturing of the skull. Rupture of traumatic aneurysms occur in up to 50% of cases and are typically delayed from days to weeks following the initiating trauma. We report a case of a 22-year-old man who was punched to the head. He was rendered unconscious but recovered and had a GCS of 14 on admission. CT scans showed subarachnoid hemorrhage. An initial angiogram was negative but on day 7 following the incident he was noted to have a 1 mm aneurysm of the posterior inferior cerebellar artery on CT angiogram. On day 9 he collapsed and was found to have new subarachnoid hemorrhage and to have a 4.0 mm × 3.7 mm. He did not recover and was declared brain dead on day 12. At autopsy, there was a 4.0 mm aneurysm of the left PICA just after the origin of the artery. Histological examination confirmed the presence of a traumatic false aneurysm in the left PICA. This case study shows sequential radiological imaging with pathologiocal correlation.
authors.affiliation: Eastern Ontario Forensic Pathology Unit of the Ontario Forensic Pathology Service, Department of Anatomical Pathology, Eastern Ontario Regional Laboratory Service, The Ottawa Hospital, Ottawa, Canada; Department of Pathology and Laboratory Medicine, University of Ottawa, Ottawa, Canada.
authors.forename: Bibianna
authors.initials: B
authors.lastname: Purgina
authors.affiliation: Eastern Ontario Forensic Pathology Unit of the Ontario Forensic Pathology Service, Department of Anatomical Pathology, Eastern Ontario Regional Laboratory Service, The Ottawa Hospital, Ottawa, Canada; Department of Pathology and Laboratory Medicine, University of Ottawa, Ottawa, Canada. Electronic address: cmilroy@toh.on.ca.
authors.forename: Christopher Mark
authors.initials: CM
authors.lastname: Milroy
mesh_terms: D017541:Aneurysm, False / Q000209:etiology / Q000473:pathology; D017542:Aneurysm, Ruptured / Q000209:etiology / Q000473:pathology*; D001926:Brain Death; D049429:Forensic Pathology; D016489:Head Injuries, Closed / Q000150:complications; D006801:Humans; D002532:Intracranial Aneurysm / Q000209:etiology / Q000473:pathology*; D008297:Male; D011859:Radiography; D013345:Subarachnoid Hemorrhage / Q000000981:diagnostic imaging / Q000473:pathology; D014754:Violence; D055815:Young Adult
keywords: Aneurysm; False; Intracranial; Rupture PICA; Traumatic