Traumatic intracranial aneurysm in blast penetrating brain injury: 1 case report and literature review

Abstract

Objective To analyze our treatment experience of a case of traumatic intracranial aneurysm complicated with blast penetrating brain injury. Methods A case of traumatic brain injury (TBI) wounded by shrapnel was admitted in our department in December 2020. We performed emergency tracheostomy and external ventricular drainage. Computed tomography angiogram (CTA) on the second day after injury revealed a left-sided pericallosal artery forming stump with approximately 2 mm of blind end thickening, no pseudoaneurysm bodies, or aneurysm cavity formation. On the 7th day, because of the refractory cerebral edema, we performed right side craniotomy and cleared the necrotic brain tissue. The pseudoaneurysm hemorrhaged on day 17 after injury, and the aneurysm and the parent artery were embolized by interventional methods. Results The patient regained consciousness on the 44th day after injury and could follow instructions. Three months later he had a Glasgow coma scale (GCS) score of 15 with left limb hemiparesis. There were no recurrences of the aneurysm during 12 months of clinical follow-up. Conclusion Severe brain edema after penetrating shrapnel injuries often requires early decompression. Intracranial tarumatic aneurysms can arise after shrapnel penetrates, and require early screening management.

Keywords

• traumatic brain injury
• blast injury
• shrapnel
• traumatic intracranial aneurysm