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J Korean Soc Emerg Med > Volume 18(6); 2007 > Article
Journal of The Korean Society of Emergency Medicine 2007;18(6): 609-614.
The Diagnostic Method and Importance of Intracranial Pseudoaneurysm Developed by Head trauma: Case report
Jae Seung Bang, Myung Chun Kim
1Department of Neurosurgery of East-West Neo Medical Center, Kyung Hee University, School of Medicine, Seoul, Korea.
2Department of Emergency Medicine of East-West Neo Medical Center, Kyung Hee University, School of Medicine, Seoul, Korea. edkmc@chol.com
ABSTRACT
Traumatic intracranial pseudoaneurysms are rare and it is easy to overlook the evaluation of intracranial vascular injury in head trauma patients in the emergency room. If the result of missing an intracranial aneurysm however is catastrophic. I describe a case of a patient with intracranial internal carotid artery (ICA) pseudoaneurysm after head trauma and stress the importance of obtaining a three-dimensional-computed tomogram angiography (3DCTA) in cases of patients with skull base fracture or eyeball pain. We report a case which a patient complained of severe headache and right eyeball pain after head trauma. 3D-CTA revealed carotid-cavernous fistula and pseudoaneurysm of the right ICA. After performing transfemoral carotid angiography (TFCA) and a balloon occlusion test, we carried out endovascular trapping of ICA and extracranial-intracranial (EC-IC) bypass surgery. Afterward, the patient was discharged without neurological deficit after two weeks. We recommended 3D-CTA in cases of head trauma when the patient has skull base fracture or sphenoid sinus fracture.
Key words: Head Trauma, Pseudoaneurysm, 3D-CTA
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