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Sutural Epidermoid Cyst
Joseph Junewick, MD FACR
over 5 years ago
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Intracranial Psuedoaneurysm - Nonaccidental Trauma

Case Detail

Anatomy: Brain-Spine
Junewick
Joseph Junewick, MD FACR
Diagnostic Category: Trauma
Created: over 5 years ago
Updated: over 5 years ago
Tags: PEDS
Modality/Study Types: MR CT
Activities:
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History

2 month old female with lethargy and seizure.


Case Images


Diagnosis

Intracranial Psuedoaneurysm – Nonaccidental Trauma

Findings

CT – Initial imaging reveals bi-parietal skull fractures, left greater than right frontal edema, and extra-axial hemorrhage which is focally prominent along the anterior interhemispheric fissure.

MR – T2-FLAIR image with interval enlargement of bilateral holohemispheric subdural hemorrhages; subtle heterogeneous anterior subfalcine signal corresponding to aneurysm.

CTA – Multiplanar 2D and volume rendered 3D images show a large saccular aneurysm emanating from the anterior cerebral artery.

Discussion

Traumatic intracranial aneurysms are rare, occurring in fewer than 1% of patients with cerebral aneurysms. They can occur following direct (penetrating injury or bone shard) or indirect (vessel impact on dural reflection or boney prominence) vessel injury. Post-traumatic intracranial aneurysms are more common in the pediatric population. Post-traumatic aneurysms can be categorized histologically as true, false, or mixed, with false aneurysms being the most common. In this case, anterior cerebral artery was likely injured by the falx during impact or shaking.

Reference

Benoit BG, Wortzman G. Traumatic cerebral aneurysms: Clinical features and natural history. J Neurol Neurosurg Psychiatry. 1973 February; 36(1): 127–138.



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