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False aneurysm secondary to penetration of the brain through orbitofacial wounds

Report of two cases

Darwin J. Ferry Jr. and Ludwig G. Kempe

R ecently , Hammon 4 reported 2187 cases of penetrating wounds of the brain treated in a 20-month period in one U.S. Army hospital in Vietnam. Thirty of these patients had orbitofacial wounds (25 orbital, 5 facial). Two of the 30 patients developed false aneurysms and were subsequently operated on at Walter Reed General Hospital. These were the only known arterial complications in the 2187 patients. Three similar arterial injuries have been previously reported, each of which also resulted from orbitofacial penetration. The following case reports were prompted

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False aneurysm of the cavernous carotid artery and progressive external ophthalmoplegia after transsphenoidal hypophysectomy

Case report

Wayne S. Paullus Jr., Christopher W. Norwood, and Howard W. Morgan

the first division of the fifth cranial nerve on the left. There was no progression of the neurological signs over the next 4 days. On the sixth postoperative day he developed a rapidly progressive complete left external ophthalmoplegia, with minimal proptosis in the left eye. Angiography disclosed a large false aneurysm of the left cavernous carotid artery in its anterior third with a minimal carotid-cavernous fistula component ( Fig. 1 left ). There was excellent filling of the left cerebral circulation from the right with cross-compression. Although it was felt

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Traumatic false aneurysm of the superior cerebellar artery simulating posterior fossa tumor

Case report

H. Howard Cockrill Jr., John P. Jimenez, and John A. Goree

T raumatic false aneurysms are reported in the anterior circulation with increasing frequency, 1–4, 6, 8, 10, 13 but review of the literature revealed only one example of this type of aneurysm in the posterior fossa. 5 The patient, a Viet Nam war casualty, had a traumatic aneurysm involving the left superior cerebellar artery, secondary to a penetrating wound to the brain. The present case is the first reported instance of a traumatic false aneurysm in the posterior fossa following closed head trauma. This case is also of interest because the aneurysm

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Giant traumatic false aneurysm of the internal carotid artery associated with a carotid-cavernous fistula

Case report

S. V. Ramana Reddy and Thoralf M. Sundt Jr.

T he association of carotid-cavernous fistula with a concomitant false aneurysm of the intracranial internal carotid artery (ICA) is uncommon, and only a few cases have been reported in the literature. 1, 5, 6, 9, 11, 21, 22 In most of these cases, the abnormalities were secondary to head injuries, 1, 11, 22 although occasionally they resulted from trauma during transsphenoidal surgery. 9, 13 The few reported cases were successfully treated by a trapping procedure alone, 9 trapping combined with controlled muscle embolization, 1, 13, 22 or more recently

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False Aneurysms of the Middle Meningeal Artery

Robert A. Kuhn and Hermann Kugler

, whereas in the others early neurologic signs were not prominent. Clinical signs of the false aneurysm usually appear late, mingling with receding effects of direct cerebral injury. Disorientation, motor agitation and increased drowsiness are common. Neurological localizing signs have included relatively sudden onset of unilateral paresis, extensor plantar reflexes, or reflex asymmetries. If these warning signals pass unnoticed, catastrophic bleeding produces sharp alteration of vital signs. Unilateral pupillary dilatation, hemiplegia, and progressive deepening of the

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Cerebral False Aneurysm Formation in Closed Head Trauma

Case Report

Donald R. Smith and Ludwig G. Kempe

arise after aneurysmal dilatation and delayed rupture; aneurysmal enlargement of the meningeal arteries with subsequent epidural hematomas are rather commonly reported. 5, 7 Aneurysms of the intradural, cortical vessels have been previously discussed but are seen much less frequently. These cases, with rare exceptions, 4, 10 have all been the end result of penetrating injuries either from foreign bodies, bony fragments, or previous surgery. We are reporting a case in which a posttraumatic false aneurysm occurred on a middle cerebral branch artery following closed

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Importance of Angiography in Identifying False Aneurysm of the Middle Meningeal Artery as a Cause of Extradural Hematoma

Case Report

Ibrahim Higazi, Ahmed El-Banhawy, and F. El-Nady

T here are 11 cases of posttraumatic false aneurysm of the middle meningeal artery in the world literature. 2, 5, 7, 8, 10, 12–14 Six of them were complicated by extradural hematoma. 2, 5, 12, 14 The purpose of this paper is to report one more case causing extradural hematoma and to emphasize the importance of angiography in diagnosis and treatment. Case Report A 22-year-old man was involved in a car accident. He momentarily lost consciousness. For the next 10 days, except for headache, he felt fairly well. On the morning of the 11th day he was found

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Growing blood clot mimicking an aneurysm on postoperative computerized tomography and magnetic resonance imaging studies

Case report and review of the literature

Alexander Bertalanffy, Wolfgang Dietrich, Martin Aichholzer, Karl Hittmair, and Thomas Czech

-flow false aneurysm, a thrombosed false aneurysm, or a blood clot ( Fig. 3 ). Selective intraarterial digital subtraction angiographic studies of the left ICA revealed no evidence of a perfused aneurysm. The course of the vessel was normal in all views, and only a minimal reduction of its diameter and smooth vessel walls was seen ( Fig. 4 ). Summarizing the radiological findings, they were consistent with thrombosed blood, most likely within a false aneurysm of the supraclinoid ICA. Fearing a hemorrhage, we therefore chose surgical revision. Fig. 1. Postoperative

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Chronic extradural hematomas

A study of 21 cases

Tsutomu Iwakuma and Carl V. Brunngraber

was identified. Extradural hemorrhage in two cases with a false aneurysm of the middle meningeal artery was probably due to rupture of the artery. In Case 13 there was also a subdural hematoma and in Case 14 an intracerebral hematoma. Pathological Findings An encapsulated extradural hematoma was found in two cases (Cases 4 and 21) ( Fig. 2 ). The content was a solid clot in Case 4 and clot with brown fluid in Case 21. The time interval from injury to operation in Case 4 was 41 days and in Case 21 more than 24 days, suggesting that the time for formation of

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False cerebral aneurysm associated with metastatic carcinoma of the brain

Case report

Abdon Reina and Robert B. Seal

T here have been several reports of false aneurysm of the middle meningeal artery 2–6 and cerebrum, 7 all of traumatic origin. To our knowledge no case of false cerebral aneurysm associated with metastatic carcinoma of the brain, and without history of trauma, has been published. We are presenting such a case. Case Report This 66-year-old man was seen for the first time on August 8, 1971, because of progressive confusion, disorientation, and slowness of mental function of 4 months' duration, and headache, apathy, poor balance, and mental confusion for