PDF(Pubmed)
Abstract：
UNASSIGNED: Traumatic intracranial aneurysm (TICA) accounts for approximately 1% of cerebral aneurysms. There are few reports of TICA limited to the posterior inferior cerebellar artery (PICA-TICA).
UNASSIGNED: A 69-year-old woman fell into a shallow river, bruising her head and chest, and was admitted to our emergency department with disorientation. Computed tomography (CT) showed subarachnoid hemorrhage (SAH), intraventricular hemorrhage (IVH), left temporal lobe contusion, and fractures of the right temporal bone. A cerebral CT angiogram revealed no vascular abnormalities or aneurysms. The patient was in a semi-comatose state 2 h later, and CT showed worsening SAH. A cerebral angiogram revealed an 11 mm aneurysm of the anterior medullary segment of the right PICA. We attempted intra-aneurysmal embolization intending to preserve the PICA, but the aneurysmal neck was thin, and the microcatheter could not be placed in a stable position. Therefore, n-butyl-2-cyanoacrylate (NBCA) was injected to embolize the aneurysm. When the microcatheter was removed, NBCA was scattered distally in the PICA, and the distal PICA was occluded. The aneurysm could be embolized, but there was an increase in hemorrhagic contusion in the left temporal lobe. Decompression craniectomy was performed, but she died due to hemorrhagic contusion and uncal herniation 6 days after surgery.
UNASSIGNED: PICA-TICA is often accompanied by IVH and SAH, and there are some reports of cases with a vascular anomaly of the posterior circulation. Since TICA is at risk of rapid growth and rupture, an early and appropriate diagnosis is important.
UNASSIGNED: A 69-year-old woman fell into a shallow river, bruising her head and chest, and was admitted to our emergency department with disorientation. Computed tomography (CT) showed subarachnoid hemorrhage (SAH), intraventricular hemorrhage (IVH), left temporal lobe contusion, and fractures of the right temporal bone. A cerebral CT angiogram revealed no vascular abnormalities or aneurysms. The patient was in a semi-comatose state 2 h later, and CT showed worsening SAH. A cerebral angiogram revealed an 11 mm aneurysm of the anterior medullary segment of the right PICA. We attempted intra-aneurysmal embolization intending to preserve the PICA, but the aneurysmal neck was thin, and the microcatheter could not be placed in a stable position. Therefore, n-butyl-2-cyanoacrylate (NBCA) was injected to embolize the aneurysm. When the microcatheter was removed, NBCA was scattered distally in the PICA, and the distal PICA was occluded. The aneurysm could be embolized, but there was an increase in hemorrhagic contusion in the left temporal lobe. Decompression craniectomy was performed, but she died due to hemorrhagic contusion and uncal herniation 6 days after surgery.
UNASSIGNED: PICA-TICA is often accompanied by IVH and SAH, and there are some reports of cases with a vascular anomaly of the posterior circulation. Since TICA is at risk of rapid growth and rupture, an early and appropriate diagnosis is important.
摘要：
■创伤性颅内动脉瘤（TICA）约占脑动脉瘤的1％。很少有TICA仅限于小脑后下动脉（PICA-TICA）的报道。
■一名69岁的妇女掉进了一条浅水河里,擦伤她的头部和胸部,因为迷失方向被送进急诊室.计算机断层扫描（CT）显示蛛网膜下腔出血（SAH），脑室内出血（IVH），左颞叶挫伤,右颞骨骨折.脑部CT血管造影显示无血管异常或动脉瘤。2小时后患者处于半昏迷状态，CT显示SAH恶化。脑血管造影显示右侧PICA前髓段有11毫米的动脉瘤。我们尝试动脉瘤内栓塞以保留PICA，但是动脉瘤颈很薄，微导管不能放置在一个稳定的位置。因此,注射2-氰基丙烯酸正丁酯(NBCA)以栓塞动脉瘤。当移除微导管时，NBCA散布在PICA的远端，远端PICA闭塞。动脉瘤可能被栓塞,但左颞叶出血性挫伤增加.进行减压开颅手术,但手术后6天，她死于出血性挫伤和钩骨疝。
■PICA-TICA通常伴有IVH和SAH，并且有一些后循环血管异常的病例报告。由于TICA有快速增长和破裂的风险，早期和适当的诊断是重要的。
■一名69岁的妇女掉进了一条浅水河里,擦伤她的头部和胸部,因为迷失方向被送进急诊室.计算机断层扫描（CT）显示蛛网膜下腔出血（SAH），脑室内出血（IVH），左颞叶挫伤,右颞骨骨折.脑部CT血管造影显示无血管异常或动脉瘤。2小时后患者处于半昏迷状态，CT显示SAH恶化。脑血管造影显示右侧PICA前髓段有11毫米的动脉瘤。我们尝试动脉瘤内栓塞以保留PICA，但是动脉瘤颈很薄，微导管不能放置在一个稳定的位置。因此,注射2-氰基丙烯酸正丁酯(NBCA)以栓塞动脉瘤。当移除微导管时，NBCA散布在PICA的远端，远端PICA闭塞。动脉瘤可能被栓塞,但左颞叶出血性挫伤增加.进行减压开颅手术,但手术后6天，她死于出血性挫伤和钩骨疝。
■PICA-TICA通常伴有IVH和SAH，并且有一些后循环血管异常的病例报告。由于TICA有快速增长和破裂的风险，早期和适当的诊断是重要的。
