Shah Kushal J, Jones Aaron M, Arnold Paul M, Ebersole Koji
Department of Neurosurgery, University of Kansas Medical Center, Kansas City, Kansas, USA.
Department of Neurosurgery, University of Kansas, Kansas City, Kansas, USA.
J Neurointerv Surg. 2016 Jan;8(1):e3. doi: 10.1136/neurintsurg-2014-011410.rep. Epub 2014 Dec 17.
Traumatic intracranial pseudoaneurysms are a rare but severe complication following arterial injury. Pseudoaneurysm formation can occur secondary to blunt or penetrating trauma or iatrogenic injury. We report a case of traumatic pseudoaneurysm secondary to placement of an intracranial pressure (ICP) monitor. A 27-year-old man was involved in a motorcycle accident resulting in multiple intracranial hemorrhages. The patient underwent craniectomy and placement of an ICP monitor. 17 days later he developed dilation of his left pupil, with imaging demonstrating a new hemorrhage in the vicinity of the previous ICP monitor. A cerebral angiogram confirmed a left-sided distal M4 pseudoaneurysm which was treated by n-butyl cyanoacrylate embolization. Intracranial pseudoaneurysm formation following neurosurgical procedures is uncommon. Delayed intracranial hemorrhage in a region of prior intracranial manipulation, even following a procedure as 'routine' as placement of an ICP monitor, should raise the suspicion for this rare but potentially lethal complication.
创伤性颅内假性动脉瘤是动脉损伤后一种罕见但严重的并发症。假性动脉瘤的形成可继发于钝性或穿透性创伤或医源性损伤。我们报告一例因放置颅内压（ICP）监测器继发的创伤性假性动脉瘤病例。一名27岁男性遭遇摩托车事故，导致多处颅内出血。患者接受了颅骨切除术并放置了ICP监测器。17天后，他左侧瞳孔散大，影像学检查显示在先前ICP监测器附近出现新的出血。脑血管造影证实为左侧M4段远端假性动脉瘤，通过氰基丙烯酸正丁酯栓塞治疗。神经外科手术后颅内假性动脉瘤的形成并不常见。即使在像放置ICP监测器这样“常规”的手术后，在先前颅内操作区域出现延迟性颅内出血，也应怀疑这种罕见但可能致命的并发症。
