Shim Yu Shik
Department of Neurosurgery, Inha University Hospital, Incheon, Korea.
Korean J Neurotrauma. 2021 Nov 12;18(1):98-102. doi: 10.13004/kjnt.2022.18.e2. eCollection 2022 Apr.
We describe the case of a 57-year-old man who had traumatic subarachnoid hemorrhage (SAH) with a delayed growth of an ophthalmic artery aneurysm. Initially, computed tomography angiography did not show any evidence of aneurysmal dilatation, but digital subtraction angiography (DSA) after 3 days showed small aneurysmal dilatation or dissection of a presumed lesion. Early intervention or surgery was difficult because of the patient's unstable condition. The SAH was completely resolved within 7 days. Follow-up DSA was performed 2 weeks later and it revealed an increasing size and shape change. We treated the patient with coil embolization, partially filling the aneurysm to save the ophthalmic artery. DSA performed 6 months later indicated that the aneurysm was completely embolized, sparing the ophthalmic artery. In traumatic SAH, delayed growth of the aneurysm should always be considered, and follow-up imaging should be performed. Partial embolization to save the ophthalmic artery can be one of the treatment modalities for selected patients.
我们描述了一例57岁男性患者,其患有创伤性蛛网膜下腔出血(SAH),伴有眼动脉动脉瘤的延迟生长。最初,计算机断层扫描血管造影未显示任何动脉瘤扩张的迹象,但3天后的数字减影血管造影(DSA)显示一个推测病变处有小的动脉瘤扩张或夹层。由于患者病情不稳定,早期干预或手术困难。SAH在7天内完全消退。2周后进行了随访DSA,结果显示动脉瘤大小增加且形状改变。我们对患者进行了弹簧圈栓塞治疗,部分填充动脉瘤以保留眼动脉。6个月后进行的DSA显示动脉瘤已完全栓塞,眼动脉得以保留。在创伤性SAH中,应始终考虑动脉瘤的延迟生长,并进行随访成像。对于选定的患者,部分栓塞以保留眼动脉可以是一种治疗方式。