Traumatic Intracranial Aneurysm Formation following Closed Head Injury

Abstract

Background: Traumatic intracranial aneurysms are rare conditions that can be a result of non-penetrating head trauma. We report the
occurrence of intracranial aneurysms in patients with traumatic brain injury.
Methods: All diagnostic cerebral angiograms performed in patients with traumatic brain injury at a level I trauma center from January
2006 to July 2007 were reviewed.
Results: Diagnostic cerebral angiography was performed in 74 patients with the diagnosis of closed head injury. A total of 4 traumatic
intracranial pseudoaneurysms were found in 4 patients, two in the supraclinoid segment of the internal carotid artery, one in the cavernous segment of the internal carotid artery and one in the paraophthalmic segment of the internal carotid artery. Two patients were
treated with coil embolization. One patient had follow up imaging on which there was no change in the size and morphology of the
aneurysm.
Conclusion: Intracranial aneurysms can develop in patients with closed head injury presumably related to shear or rotational injury. It is
unclear whether these aneurysms should be classified as traumatic intracranial aneurysms or pseudoaneurysms, but the pathological
findings frequently reveal disruption of the three vascular layers fulfilling the definition of pseudoaneurysm. For these reason we favor
the name of post-traumatic intracranial pseudoaneurysms.