title: Subarachnoid haemorrhage secondary to traumatic intracranial aneurysm of the posterior cerebral circulation: case series and literature review.
abstract: To identify the clinical features, rebleed risk, timing and method of diagnosis, complications and outcome for subarachnoid haemorrhage (SAH) from traumatic intracranial aneurysm (TICA) of the posterior circulation. Subjects included 26 patients aged 3-54 (mean 24.8).
  
  
  
  Case series and literature search to identify all reported cases.
  
  
  
  In our series, two of three cases were fatal as a result of rebleed, and one case had a good outcome with no deficit, following prompt diagnosis and embolisation. Our key findings from the literature review were: 30.7 % of patients were age 16 and under; 88 % had an acute drop in consciousness, 46 % in a delayed manner; the mean time to diagnosis was 7.5 days; initial cerebrovascular imaging was normal in 23 %; the rebleed rate was 23 %; 61 % required emergency diversion of cerebrospinal fluid; 11 % developed vasospasm requiring treatment; 19.2 % had deficits that rendered them unable to live independently. The mortality rate was 27 %.
  
  
  
  SAH from ruptured posterior circulation TICA is associated with significant morbidity and mortality. A high index of suspicion as well as prompt diagnosis, repeat imaging in selected cases, and treatment of any associated TICA can be crucial to a favourable outcome.
authors.affiliation: Department of Neurosurgery, Brighton and Sussex University Hospitals NHS Trust, Eastern Rd, Brighton, East Sussex, BN2 5BE, UK. rmgds7@gmail.com.|Department of Neurosurgery, King's College Hopsital, Denmark Hill, London, SE5 9RS, UK. rmgds7@gmail.com.
authors.forename: Ruth-Mary
authors.initials: RM
authors.lastname: deSouza
authors.affiliation: Department of Neurosurgery, Brighton and Sussex University Hospitals NHS Trust, Eastern Rd, Brighton, East Sussex, BN2 5BE, UK.
authors.forename: Munirih
authors.initials: M
authors.lastname: Shah
authors.affiliation: Department of Neurosurgery, Brighton and Sussex University Hospitals NHS Trust, Eastern Rd, Brighton, East Sussex, BN2 5BE, UK.
authors.forename: Panayiotis
authors.initials: P
authors.lastname: Koumellis
authors.affiliation: Department of Neurosurgery, Brighton and Sussex University Hospitals NHS Trust, Eastern Rd, Brighton, East Sussex, BN2 5BE, UK.
authors.forename: Mansoor
authors.initials: M
authors.lastname: Foroughi
mesh_terms: D000293:Adolescent; D000328:Adult; D017542:Aneurysm, Ruptured / Q000150:complications / Q000175:diagnosis / Q000401:mortality; D000070642:Brain Injuries, Traumatic / Q000150:complications / Q000175:diagnosis / Q000401:mortality; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications / Q000175:diagnosis / Q000401:mortality; D008297:Male; D008875:Middle Aged; D013345:Subarachnoid Hemorrhage / Q000175:diagnosis / Q000209:etiology / Q000401:mortality; D055815:Young Adult
keywords: Delayed; Haemorrhage; Posterior circulation; Pseudoaneurysm; Subarachnoid; TICA; Trauma