Cho Won-Sang, Batchuluun Batbold, Lee Seung Jin, Kang Hyun-Seung, Kim Jeong Eun
Department of Neurosurgery, Kangwon National University Hospital, Chuncheon, ROK.
Neurol Med Chir (Tokyo). 2011;51(3):217-21. doi: 10.2176/nmc.51.217.
A 67-year-old man presented with a case of recurrent subdural hematomas (SDHs) from a pseudoaneurysm at the cortical artery after mild head trauma. He had undergone two episodes of burr hole trephination and evacuation of SDH in a 6-day interval. Review of previous imaging findings and additional cerebral angiography then identified a pseudoaneurysm arising from the precentral branch of the middle cerebral artery. Acute rebleeding suddenly occurred, and the leak point on the cortical artery was completely repaired with a single suture. SDH from pseudoaneurysm after mild head injury is very unusual. The high morbidity and mortality rates necessitate early detection, but the rarity of this type of injury makes detection difficult. If the clinical course is not easily explainable and is worse than the severity of trauma, repeated SDHs occur, or abnormal lesions and/or subarachnoid hemorrhage are identified, computed tomography or magnetic resonance imaging with contrast medium should be performed to identify the underlying cerebrovascular diseases and determine whether cerebral angiography is necessary.
一名67岁男性因轻度头部外伤后皮质动脉假性动脉瘤导致复发性硬膜下血肿（SDH）前来就诊。他在6天内接受了两次钻孔引流术以清除SDH。回顾先前的影像学检查结果并进行额外的脑血管造影后，发现一个由大脑中动脉中央前分支形成的假性动脉瘤。急性再出血突然发生，通过单针缝合完全修复了皮质动脉上的漏血点。轻度头部损伤后由假性动脉瘤引起的SDH非常罕见。其高发病率和死亡率需要早期检测，但这种类型损伤的罕见性使得检测困难。如果临床过程难以解释且比创伤严重程度更差、反复发生SDH、发现异常病变和/或蛛网膜下腔出血，应进行计算机断层扫描或增强磁共振成像以识别潜在的脑血管疾病，并确定是否需要进行脑血管造影。
