Detection and successful endovascular treatment for a de novo intracranial pseudoaneurysm in early phase after traumatic brain injury
Traumatic intracranial pseudoaneurysm (TIP) after head trauma is rare, but it frequently ruptures in early phase. Although early detection and prompt treatment is important, the details are still unknown. Here, we report a case who was diagnosed with TIP in early phase after trauma and underwent end...
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| Format: | Article |
| Language: | English |
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KeAi Communications Co., Ltd.
2023-12-01
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| Series: | Brain Hemorrhages |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2589238X2300013X |
| _version_ | 1797382825534554112 |
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| author | Sosho Kajiwara Shuichi Tanoue Masaru Hirohata Yasuharu Takeuchi Yu Hasegawa Kimihiko Orito Toshi Abe Motohiro Morioka |
| author_facet | Sosho Kajiwara Shuichi Tanoue Masaru Hirohata Yasuharu Takeuchi Yu Hasegawa Kimihiko Orito Toshi Abe Motohiro Morioka |
| author_sort | Sosho Kajiwara |
| collection | DOAJ |
| description | Traumatic intracranial pseudoaneurysm (TIP) after head trauma is rare, but it frequently ruptures in early phase. Although early detection and prompt treatment is important, the details are still unknown. Here, we report a case who was diagnosed with TIP in early phase after trauma and underwent endovascular treatment with parent artery occlusion (PAO), resulted in a good outcome.A 17-year-old boy hospitalized for severe head trauma. Computed tomography (CT) revealed an acute epidural hematoma (AEDH) in the right middle fossa along with the fracture from the right lateral optic canal to the right superior orbital fissure, and CT angiography showed no obvious aneurysm at that time. CT angiography on 5 days showed an irregular shaped aneurysm at a C2-C3 posterior wall in the right internal carotid artery (ICA). As balloon occlusion test revealed complete ischemic tolerance, endovascular PAO was performed without any bypass. Postoperative imaging showed no hypoperfusion area.Prompt diagnosis for TIP is important and the patients with skull fracture around ICA area are considered to provide cerebral angiography in early phase. In addition, TIP in early phase has a risk of rupture, suitable treatment strategy using BOT is important for the favorable outcome in those patients. |
| first_indexed | 2024-03-08T21:11:01Z |
| format | Article |
| id | doaj.art-03340bbe999c4bc8bccd8296776fafb4 |
| institution | Directory Open Access Journal |
| issn | 2589-238X |
| language | English |
| last_indexed | 2024-03-08T21:11:01Z |
| publishDate | 2023-12-01 |
| publisher | KeAi Communications Co., Ltd. |
| record_format | Article |
| series | Brain Hemorrhages |
| spelling | doaj.art-03340bbe999c4bc8bccd8296776fafb42023-12-22T05:34:01ZengKeAi Communications Co., Ltd.Brain Hemorrhages2589-238X2023-12-0144210214Detection and successful endovascular treatment for a de novo intracranial pseudoaneurysm in early phase after traumatic brain injurySosho Kajiwara0Shuichi Tanoue1Masaru Hirohata2Yasuharu Takeuchi3Yu Hasegawa4Kimihiko Orito5Toshi Abe6Motohiro Morioka7Departments of Neurosurgery, Kurume University School of Medicine, 67, Asahimachi, Kurume, Fukuoka 8300011, Japan; Corresponding author at: Departments of Neurosurgery, Kurume University School of Medicine, 67, Asahimachi, Kurume, Fukuoka 8300011, Japan.Departments of Radiology, Kurume University School of Medicine, 67, Asahimachi, Kurume, Fukuoka 8300011, JapanDepartments of Neurosurgery, Kurume University School of Medicine, 67, Asahimachi, Kurume, Fukuoka 8300011, JapanDepartments of Radiology, Kurume University School of Medicine, 67, Asahimachi, Kurume, Fukuoka 8300011, JapanDepartments of Neurosurgery, Kurume University School of Medicine, 67, Asahimachi, Kurume, Fukuoka 8300011, Japan; Department of Pharmaceutical Sciences, School of Pharmacy at Fukuoka, International University of Health and Welfare, 137-1, Okawa, Fukuoka 8318501, JapanDepartments of Neurosurgery, Kurume University School of Medicine, 67, Asahimachi, Kurume, Fukuoka 8300011, JapanDepartments of Radiology, Kurume University School of Medicine, 67, Asahimachi, Kurume, Fukuoka 8300011, JapanDepartments of Neurosurgery, Kurume University School of Medicine, 67, Asahimachi, Kurume, Fukuoka 8300011, JapanTraumatic intracranial pseudoaneurysm (TIP) after head trauma is rare, but it frequently ruptures in early phase. Although early detection and prompt treatment is important, the details are still unknown. Here, we report a case who was diagnosed with TIP in early phase after trauma and underwent endovascular treatment with parent artery occlusion (PAO), resulted in a good outcome.A 17-year-old boy hospitalized for severe head trauma. Computed tomography (CT) revealed an acute epidural hematoma (AEDH) in the right middle fossa along with the fracture from the right lateral optic canal to the right superior orbital fissure, and CT angiography showed no obvious aneurysm at that time. CT angiography on 5 days showed an irregular shaped aneurysm at a C2-C3 posterior wall in the right internal carotid artery (ICA). As balloon occlusion test revealed complete ischemic tolerance, endovascular PAO was performed without any bypass. Postoperative imaging showed no hypoperfusion area.Prompt diagnosis for TIP is important and the patients with skull fracture around ICA area are considered to provide cerebral angiography in early phase. In addition, TIP in early phase has a risk of rupture, suitable treatment strategy using BOT is important for the favorable outcome in those patients.http://www.sciencedirect.com/science/article/pii/S2589238X2300013XHead traumaPseudoaneurysmOptic canal fractureParent artery occlusion |
| spellingShingle | Sosho Kajiwara Shuichi Tanoue Masaru Hirohata Yasuharu Takeuchi Yu Hasegawa Kimihiko Orito Toshi Abe Motohiro Morioka Detection and successful endovascular treatment for a de novo intracranial pseudoaneurysm in early phase after traumatic brain injury Brain Hemorrhages Head trauma Pseudoaneurysm Optic canal fracture Parent artery occlusion |
| title | Detection and successful endovascular treatment for a de novo intracranial pseudoaneurysm in early phase after traumatic brain injury |
| title_full | Detection and successful endovascular treatment for a de novo intracranial pseudoaneurysm in early phase after traumatic brain injury |
| title_fullStr | Detection and successful endovascular treatment for a de novo intracranial pseudoaneurysm in early phase after traumatic brain injury |
| title_full_unstemmed | Detection and successful endovascular treatment for a de novo intracranial pseudoaneurysm in early phase after traumatic brain injury |
| title_short | Detection and successful endovascular treatment for a de novo intracranial pseudoaneurysm in early phase after traumatic brain injury |
| title_sort | detection and successful endovascular treatment for a de novo intracranial pseudoaneurysm in early phase after traumatic brain injury |
| topic | Head trauma Pseudoaneurysm Optic canal fracture Parent artery occlusion |
| url | http://www.sciencedirect.com/science/article/pii/S2589238X2300013X |
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