Document Detail

The relationship of blunt head trauma, subarachnoid hemorrhage, and rupture of pre-existing intracranial saccular aneurysms.
MedLine Citation:
PMID:  10763504     Owner:  NLM     Status:  MEDLINE    
Patients with a history of closed head trauma and subarachnoid hemorrhage are uncommonly diagnosed with an intracranial saccular aneurysm. This study presents a group of patients in whom a pre-existing aneurysm was discovered during work-up for traumatic subarachnoid hemorrhage. Without an accurate pre-trauma clinical history, it is difficult to define the relationship between trauma and the rupture of a pre-existing intracranial saccular aneurysm. We retrospectively reviewed 130 patients who presented to Detroit Receiving Hospital between 1993 and 1997 with a diagnosis of subarachnoid hemorrhage (SAH). Of these 130 patients, 70 were spontaneous, and 60 had a history of trauma. Mechanisms of trauma include motor vehicle accident, assault, or fall from a height. Of the 60 patients with subarachnoid hemorrhage and a history of trauma, 51 (86%) did not undergo conventional four-vessel angiography, and had no further neurological sequelae. Nine patients (14%) had a suspicious quantity of blood within the basal cisterns or Sylvian fissure and had a four-vessel angiogram. Five patients (8%) were diagnosed with a saccular intracranial aneurysm, and all underwent surgical clipping of the aneurysm. We conclude that the majority of patients (92%), with post-traumatic SAH do not harbor intracranial aneurysms. However, during initial evaluation, a high level of suspicion must be entertained when post-traumatic subarachnoid hemorrhage is encountered in the basal cisterns or Sylvian fissure, as 8% of our population were diagnosed with aneurysms.
T J Cummings; R R Johnson; F G Diaz; D B Michael
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Neurological research     Volume:  22     ISSN:  0161-6412     ISO Abbreviation:  Neurol. Res.     Publication Date:  2000 Mar 
Date Detail:
Created Date:  2000-06-07     Completed Date:  2000-06-07     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7905298     Medline TA:  Neurol Res     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  165-70     Citation Subset:  IM    
Department of Neurological Surgery, Wayne State University School of Medicine, Detroit, Michigan, USA.
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MeSH Terms
Aneurysm, Ruptured / complications*,  radiography,  surgery
Cerebral Angiography
Craniocerebral Trauma / complications*
Intracranial Aneurysm / complications*,  radiography,  surgery
Middle Aged
Subarachnoid Hemorrhage / etiology*,  radiography
Tomography, X-Ray Computed
Wounds, Nonpenetrating / complications*

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