■创伤性颅内动脉瘤(TICAs)很少见,并且已知容易破裂,并且死亡率很高。
■一名87岁的男性患者,头部外伤后出现神经缺陷。计算机断层扫描(CT)显示小脑急性硬膜下血肿(ASDH)。患者接受保守治疗,住院六天后出院。两天后,病人因严重头痛而返回。CT显示ASDH已经扩大并从帐篷延伸到凸面。CT血管造影和数字减影血管造影显示左后颞下动脉分支有假性动脉瘤。由于P3段引起的TICA破裂,该患者被诊断为ASDH增大。我们使用2-氰基丙烯酸正丁酯(NBCA)对父动脉闭塞(PAO)进行了血管内介入治疗。由于左椎骨血管造影显示再生障碍性左P1段,因此通过左后交通动脉进入了父动脉。在动脉瘤附近的微导管导航后,我们向父动脉注射了33%的NBCA.注射后假性动脉瘤消失。尽管存在持续性谵妄,患者在第25天出院。
■这是由使用NBCA用PAO处理的P3段引起的TICA的第一份报告。TICA很少见;然而,a当发现头部损伤引起的血肿扩大时,必须考虑TICA.
UNASSIGNED: Traumatic intracranial aneurysms (TICAs) are rare and known to rupture easily and have a high mortality rate.
UNASSIGNED: An 87-year-old male patient with no neurological deficits presented to our hospital after head trauma. Computed tomography (CT) revealed a tentorial acute subdural hematoma (ASDH). The patient was managed conservatively and discharged home six days after hospitalization. Two days later, the patient returned with a severe headache. CT showed that the ASDH had enlarged and extended from the tentorium to the convexity. CT angiography and digital subtraction angiography revealed a pseudoaneurysm in a branch of the left posterior inferior temporal artery. The patient was diagnosed with an enlarged ASDH due to a ruptured TICA that arose from the P3 segment. We performed endovascular intervention with parent artery occlusion (PAO) using n-butyl-2-cyanoacrylate (NBCA). The parent artery was accessed through the left posterior communicating artery because left vertebral angiography revealed an aplastic left P1 segment. After navigating the microcatheter near the aneurysm, we injected 33% NBCA into the parent artery. The pseudoaneurysm disappeared after injection. The patient was discharged on hospital day 25 despite persistent delirium.
UNASSIGNED: This is the first report of a TICA arising from the P3 segment that was treated with PAO using NBCA. TICAs are rare; however, a TICA must be considered when an enlarged hematoma caused by head injury is detected.