Traumatic intracranial aneurysms.

Eleven cases of traumatic intracranial aneurysms, six saccular and five arteriovenous, are presented with an operative mortality of 22.2%, which compares favorably with the few reports in the literature. These lesions are usually associated with serious head injuries. The diagnosis is often delayed or overlooked as the surgeon's attention is distracted by the presence of an accompanying intracranial hematoma. With increasing replacement of angiography by computerized tomography in aneurysm diagnosis, these aneurysms are even more likely to escape detection. They should be suspected in any patient who deteriorates within 2 weeks of the trauma. Conservative management carries a mortality rate of about 50%. Because of their superficial location, they are amenable to successful surgical extirpation. Improved mortality depends on early recognition and surgical obliteration.