创伤性脑动脉瘤延迟破裂的临床特征及危险因素：病例系列研究
Clinical features and risk factors for delayed rupture of traumatic cerebral aneurysm: A case series.
作者信息
Sugii Masataka, Okada Kazuhiro, Ikeda Shimpei, Hara Yoshiaki, Yokobori Shoji
机构信息
Nippon Medical School Chiba Hokusoh Hospital Chiba Japan.
Department of Emergency and Critical Care Medicine Nippon Medical School Hospital Tokyo Japan.
出版信息
Acute Med Surg. 2024 Aug 21;11(1):e70000. doi: 10.1002/ams2.70000. eCollection 2024 Jan-Dec.
BACKGROUND
Traumatic cerebral aneurysms (TA) are a subset of traumatic cerebrovascular injury (TCVI). Misdiagnosis of TA can be fatal. To investigate factors that predict TA formation and the optimal timing for searching, we present four suspected cases of delayed TA rupture during hospitalization.
CASE PRESENTATION
Medical records of head injury cases to have delayed TA rupture during hospitalization between April 2021 and March 2022 were retrospectively reviewed. Of the four patients included, only one met the TCVI screening criteria. All the patients had acute subdural hematoma (ASDH) on arrival; two had delayed expansion of the traumatic subarachnoid hemorrhage (tSAH) on repeat imaging. All the patients received anticoagulants. Ruptured TA occurred between days 5 and 11. Three patients died during hospitalization.
CONCLUSION
It is advisable to suspect TA when imaging studies show ASDH on admission and intracranial hematoma expansion during hospitalization. We suggest TA screening around day 5.
背景
创伤性脑动脉瘤（TA）是创伤性脑血管损伤（TCVI）的一个子集。TA的误诊可能是致命的。为了研究预测TA形成的因素以及最佳搜索时机，我们呈现了4例住院期间延迟性TA破裂的疑似病例。
病例报告
回顾性分析了2021年4月至2022年3月期间住院期间发生延迟性TA破裂的头部损伤病例的病历。纳入的4例患者中，只有1例符合TCVI筛查标准。所有患者入院时均有急性硬膜下血肿（ASDH）；2例在重复成像时出现创伤性蛛网膜下腔出血（tSAH）延迟扩大。所有患者均接受了抗凝治疗。TA破裂发生在第5天至第11天之间。3例患者在住院期间死亡。
结论
当影像学检查显示入院时存在ASDH且住院期间颅内血肿扩大时，建议怀疑TA。我们建议在第5天左右进行TA筛查。
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