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Delayed Tentorial Subdural Hematoma Caused by Traumatic Posterior Cerebral Artery Aneurysm: A Case Report and Literature Review
- Source :
- The American Journal of Case Reports
- Publication Year :
- 2021
-
Abstract
- Patient: Male, 42-year-old Final Diagnosis: Traumatic posterior cerebral artery aneurysm Symptoms: Deterioration of mental status and disorientation Medication: — Clinical Procedure: Parent artery occlusion by endovascular approach Specialty: Neurosurgery Objective: Unusual clinical course Background: Subdural hematoma (SDH) caused by traumatic intracranial aneurysm (TICA) is rare. TICAs are known to rupture easily, resulting in a high morbidity and mortality rate. Therefore, accurate diagnosis and treatment are crucial for preserving life. We describe a case of delayed SDH in the setting of posterior cerebral artery (PCA) aneurysm. Case Report: A 42-year-old man presented with sustained head injury from a traffic accident, and was being followed-up conservatively for traumatic SDH and subarachnoid hemorrhage. Three weeks after the head trauma, the patient developed a sudden deterioration of mental status and disorientation. Computed tomography revealed de novo SDH at the cerebellar tentorium. Computed tomography angiography and magnetic resonance imaging demonstrated TICA in the PCA. The patient was diagnosed with SDH due to a ruptured PCA aneurysm at the quadrigeminal segment. To avoid SDH growth due to re-rupture of the aneurysm, parent artery occlusion was subsequently performed with no complications. The patient was discharged home 2 months after endovascular treatment, with moderate disability. Follow-up angiography 2 years after the operation showed no recanalization, and the patient had returned to work. Conclusions: TICA in the PCA can cause tentorial SDH with or without the presence of subarachnoid hemorrhage. Routine cerebrovascular assessment is crucial for head trauma with hematoma adjacent to the cerebellar tentorium. Parent artery occlusion via an endovascular procedure is an alternative treatment for TICA in the PCA that is less invasive than other approaches.
- Subjects :
- Adult
Male
medicine.medical_specialty
Subarachnoid hemorrhage
macromolecular substances
Posterior cerebral artery
Aneurysm, Ruptured
Aneurysm
Hematoma
medicine.artery
Brain Injuries, Traumatic
medicine
Humans
Hematoma, Subdural, Acute
Cerebellar tentorium
cardiovascular diseases
Computed tomography angiography
medicine.diagnostic_test
business.industry
Head injury
Endovascular Procedures
Intracranial Aneurysm
General Medicine
Articles
Subarachnoid Hemorrhage
medicine.disease
Embolization, Therapeutic
Magnetic Resonance Imaging
Cerebral Angiography
Hematoma, Subdural
Angiography
Radiology
business
Subjects
Details
- ISSN :
- 19415923
- Volume :
- 22
- Database :
- OpenAIRE
- Journal :
- The American journal of case reports
- Accession number :
- edsair.doi.dedup.....e60ab8f24d5c180007fc535f63fd7b72