Kikkawa Yuichiro, Natori Yoshihiro, Sasaki Tomio
Department of Neurosurgery, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan.
Neurol Med Chir (Tokyo). 2012;52(1):41-3. doi: 10.2176/nmc.52.41.
A 42-year-old male presented with a rare case of delayed aneurysmal formation of the intracranial ophthalmic artery after closed head injury manifesting as subarachnoid hemorrhage. Initial magnetic resonance angiography revealed no aneurysmal formation, but angiography 7 days after the injury demonstrated an intracranial ophthalmic artery aneurysm. Follow-up computed tomography angiography demonstrated enlargement of the aneurysm. The aneurysm was successfully treated by surgical resection. Histological examination revealed that the aneurysm was a pseudoaneurysm. Traumatic intracranial aneurysm (TICA) is rare and usually occurs in the peripheral arteries of the cerebral circulation or the basal portion of the internal carotid artery. The present case shows that failure to demonstrate an aneurysm on the initial angiography in the acute stage does not exclude the presence of traumatic aneurysm. This case clearly shows the time course of development of a TICA of the ophthalmic artery after closed head injury.
一名42岁男性患者，出现了罕见的闭合性颅脑损伤后颅内眼动脉动脉瘤形成延迟的病例，表现为蛛网膜下腔出血。最初的磁共振血管造影未显示动脉瘤形成，但受伤7天后的血管造影显示颅内眼动脉动脉瘤。后续的计算机断层扫描血管造影显示动脉瘤增大。该动脉瘤通过手术切除成功治疗。组织学检查显示该动脉瘤为假性动脉瘤。创伤性颅内动脉瘤（TICA）罕见，通常发生在脑循环的外周动脉或颈内动脉基部。本病例表明，急性期初始血管造影未显示动脉瘤并不排除创伤性动脉瘤的存在。该病例清楚地显示了闭合性颅脑损伤后眼动脉TICA的发展时间过程。
