{"title":"Traumatic internal carotid artery aneurysm distant from facial bone fractures treated with a flow diverter stent: A case report","authors":"Tatsuya Watanabe, Junzo Nakao, Keishun Boku, Koji Hirata, Yasukazu Totoki, Kuniharu Tasaki, Takeshi Miura, Tetsuya Hoshino, Yukei Matsumoto, Yuki Enomoto, Aiki Marushima, Yuji Matsumaru, Yoshiaki Inoue","doi":"10.1002/ams2.70034","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>Traumatic intracranial aneurysms (TICAs) can be fatal if ruptured. We report a case of a TICA, distant from facial bone fractures, successfully treated with flow diverter (FD) before rupture.</p>\n </section>\n \n <section>\n \n <h3> Case Presentation</h3>\n \n <p>A 20-year-old woman was admitted following a car accident. Initial contrast-enhanced computed tomography revealed traumatic subarachnoid hemorrhage, a 5-mm internal carotid artery aneurysm, LeFort type I + II, and mandibular fracture. On Day 8, she developed oculomotor palsy, and digital subtraction angiography revealed the aneurysm had increased to 12 mm. She started dual antiplatelet therapy (DAPT) following facial fracture repair. On Day 17, FD was placed, resulting in contrast agent stagnation within the aneurysm. Three months postinjury, her neurological symptoms improved.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>Screening for cerebrovascular injury is crucial several days following severe head trauma, even without skull base fractures. Unruptured TICA can be safely treated with FD following DAPT administration.</p>\n </section>\n </div>","PeriodicalId":7196,"journal":{"name":"Acute Medicine & Surgery","volume":"12 1","pages":""},"PeriodicalIF":1.5000,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11761364/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Acute Medicine & Surgery","FirstCategoryId":"1085","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/ams2.70034","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
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Abstract
Background
Traumatic intracranial aneurysms (TICAs) can be fatal if ruptured. We report a case of a TICA, distant from facial bone fractures, successfully treated with flow diverter (FD) before rupture.
Case Presentation
A 20-year-old woman was admitted following a car accident. Initial contrast-enhanced computed tomography revealed traumatic subarachnoid hemorrhage, a 5-mm internal carotid artery aneurysm, LeFort type I + II, and mandibular fracture. On Day 8, she developed oculomotor palsy, and digital subtraction angiography revealed the aneurysm had increased to 12 mm. She started dual antiplatelet therapy (DAPT) following facial fracture repair. On Day 17, FD was placed, resulting in contrast agent stagnation within the aneurysm. Three months postinjury, her neurological symptoms improved.
Conclusion
Screening for cerebrovascular injury is crucial several days following severe head trauma, even without skull base fractures. Unruptured TICA can be safely treated with FD following DAPT administration.
背景：外伤性颅内动脉瘤（TICAs）一旦破裂可能是致命的。我们报告一例远离面骨骨折的TICA，在骨折前成功应用分流器（FD）治疗。病例介绍：一名20岁的女性在车祸后入院。最初的增强计算机断层扫描显示外伤性蛛网膜下腔出血，一个5mm的颈内动脉瘤，LeFort I + II型和下颌骨折。第8天，患者出现动眼性麻痹，数字减影血管造影显示动脉瘤增大至12mm。面部骨折修复后开始双重抗血小板治疗（DAPT）。在第17天，放置FD，导致造影剂在动脉瘤内停滞。受伤后三个月，她的神经症状有所改善。结论：在严重颅脑外伤后的几天内进行脑血管损伤筛查是至关重要的，即使没有颅底骨折。经DAPT治疗后，FD治疗未破裂的TICA是安全的。
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