Clinical features and risk factors for delayed rupture of traumatic cerebral aneurysm: A case series

IF 1.5 Q2 MEDICINE, GENERAL & INTERNAL Acute Medicine & Surgery Pub Date : 2024-08-21 DOI:10.1002/ams2.70000

Masataka Sugii, Kazuhiro Okada, Shimpei Ikeda, Yoshiaki Hara, Shoji Yokobori

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Abstract

Background

Traumatic cerebral aneurysms (TA) are a subset of traumatic cerebrovascular injury (TCVI). Misdiagnosis of TA can be fatal. To investigate factors that predict TA formation and the optimal timing for searching, we present four suspected cases of delayed TA rupture during hospitalization.

Case Presentation

Medical records of head injury cases to have delayed TA rupture during hospitalization between April 2021 and March 2022 were retrospectively reviewed. Of the four patients included, only one met the TCVI screening criteria. All the patients had acute subdural hematoma (ASDH) on arrival; two had delayed expansion of the traumatic subarachnoid hemorrhage (tSAH) on repeat imaging. All the patients received anticoagulants. Ruptured TA occurred between days 5 and 11. Three patients died during hospitalization.

Conclusion

It is advisable to suspect TA when imaging studies show ASDH on admission and intracranial hematoma expansion during hospitalization. We suggest TA screening around day 5.

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外伤性脑动脉瘤延迟破裂的临床特征和风险因素：病例系列。

背景：外伤性脑动脉瘤（TA）是外伤性脑血管损伤（TCVI）的一个分支。外伤性脑动脉瘤的误诊可能是致命的。为了研究预测TA形成的因素和最佳搜索时机，我们介绍了四例住院期间TA延迟破裂的疑似病例：病例介绍：我们回顾性审查了2021年4月至2022年3月期间住院期间发生延迟TA破裂的颅脑损伤病例的病历。在纳入的四名患者中，只有一人符合 TCVI 筛查标准。所有患者在入院时都有急性硬膜下血肿（ASDH）；其中两名患者在复查造影时发现外伤性蛛网膜下腔出血（tSAH）延迟扩大。所有患者都接受了抗凝治疗。蛛网膜下腔出血破裂发生在第5天至第11天。三名患者在住院期间死亡：结论：当影像学检查显示入院时有 ASDH，住院期间颅内血肿扩大时，最好怀疑 TA。我们建议在第 5 天左右进行 TA 筛查。

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来源期刊

Acute Medicine & Surgery MEDICINE, GENERAL & INTERNAL-

自引率

12.50%

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审稿时长

53 weeks