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Rupture of intracranial aneurysms in patients with blunt head trauma: Review of the literature.

Abstract：

INTRODUCTION:With a prevalence of 1-5 %, intracranial aneurysms are common. However, only 20-50 % of these aneurysms will rupture during a person's lifetime. This often happens spontaneously without exogenous factors. In the present study we reviewed the literature concerning the relation between trauma and rupture of a pre-existing aneurysm. METHODS:All studies that reported a causal relation between trauma and rupture of a pre-existing aneurysm were included, irrespective of study design. They were limited though to those written in English or German. Excluded were studies with traumatic aneurysms, studies where the rupture of an aneurysm lead to trauma and studies with doubts about the order of events. RESULTS:Thirteen studies with twenty-two cases of ruptured aneurysm in context with trauma and two unpublished cases were included. Fourteen patients were involved in a fight, seven patients in a bike/motorbike/bus accident and three got hit on the head in a setting outside of interpersonal violence. The aneurysm was located in internal carotid artery in most cases (7/24). The clear majority of patients (19/24) did not survive. CONCLUSION:Arteries and aneurysms can rupture in context with head trauma although this is rarely the case. Patients after head trauma with typical blood pattern for aneurysmal SAH in the native CT scan should receive conventional angiography to exclude a vascular or aneurysmal rupture, even when CT-angiography is inconspicuous.

journal_name

Clin Neurol Neurosurg

journal_title

Clinical neurology and neurosurgery

authors

Steinmann J,Hartung B,Bostelmann R,Kaschner M,Karadag C,Muhammad S,Li L,Büttner A,Petridis AK

doi

10.1016/j.clineuro.2020.106208

subject

Has Abstract

pub_date

2020-12-01 00:00:00

pages

106208

eissn

0303-8467

issn

1872-6968

pii

S0303-8467(20)30551-5

journal_volume

199

pub_type

杂志文章,评审

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