Nathoo N, Nadvi S S
Department of Neurosurgery, Wentworth Hospital, Durban, South Africa.
Cent Afr J Med. 1999 Aug;45(8):213-7. doi: 10.4314/cajm.v45i8.8487.
Two patients with rare complications of traumatic intracranial aneurysms following penetrating cranial stab wounds are described. One patient had a good outcome despite a secondary rupture of a traumatic proximal middle cerebral artery aneurysm, while the second patient had a traumatic basilar bifurcation artery aneurysm. To our knowledge neither the survival from a secondary rupture of a traumatic intracranial aneurysm, nor the development of a basilar bifurcation aneurysm secondary to a transcranial stab wound has been described previously. Furthermore, this is the first report of the technique of deep hypothermic cardiac arrest utilized to treat a traumatic false aneurysm. Traumatic intracranial aneurysms are a rare clinical entity, most often diagnosed after rupture and often resulting in fatal haemorrhage. A high index of suspicion needs to be maintained when managing patients with transcranial stab wounds. Early surgical intervention improves outcome by preventing initial aneurysmal rupture or rebleeding.
本文描述了两名穿透性颅脑刺伤后发生创伤性颅内动脉瘤罕见并发症的患者。一名患者尽管创伤性大脑中动脉近端动脉瘤继发破裂，但预后良好，而另一名患者患有创伤性基底动脉分叉部动脉瘤。据我们所知，此前尚未有关于创伤性颅内动脉瘤继发破裂后存活以及经颅刺伤继发基底动脉分叉部动脉瘤发生的报道。此外，这是首次报道采用深低温心脏停搏技术治疗创伤性假性动脉瘤。创伤性颅内动脉瘤是一种罕见的临床病症，大多在破裂后才得以诊断，且常导致致命性出血。在处理经颅刺伤患者时，需要保持高度的怀疑指数。早期手术干预可通过预防动脉瘤初始破裂或再出血来改善预后。
