Intracranial Hemorrhage Secondary to a Delayed Cerebral Pseudoaneurysm Rupture 18 Years after Cranial Trauma

Mikel Terceño; Sebastià Remollo; Yolanda Silva; Saima Bashir; Carlos Castaño; Joaquín Serena

doi:10.1159/000503812

Intracranial Hemorrhage Secondary to a Delayed Cerebral Pseudoaneurysm Rupture 18 Years after Cranial Trauma

Case Rep Neurol. 2019 Nov 21;11(3):325-329. doi: 10.1159/000503812. eCollection 2019 Sep-Dec.

Authors

Mikel Terceño^{1

2}, Sebastià Remollo², Yolanda Silva¹, Saima Bashir¹, Carlos Castaño², Joaquín Serena¹

Affiliations

¹ Stroke Unit, Department of Neurology, Hospital Universitari Dr. Josep Trueta de Girona, IDIBGI, Girona, Spain.
² Neurointerventional Radiology Unit, Department of Neurosciences, Hospital Germans Trias i Pujol, Badalona, Spain.

Abstract

We report the case of a 38-year-old male with a previous history of severe cranial trauma and subsequent large subdural and subarachnoid hemorrhage on whom an emergent hematoma evacuation was performed with a good outcome and follow-up. Despite a good clinical evolution, the patient experienced a further intracranial hematoma 18 years after the trauma, with severe aphasia and mild right hemiparesis. After complete etiological study, two cranial pseudoaneurysms were observed in the cerebral angiography. Endovascular treatment was successfully completed, achieving full embolization without complications. No rebleeding was detected during follow-up. The patient had a good clinical outcome at 3 months and achieved complete recovery. Cranial pseudoaneurysm rupture is a rare cause of intracerebral hemorrhage, especially if the trauma occurs years before the bleeding.

Keywords: Cranial pseudoaneurysm; Endovascular treatment; Intracranial hemorrhage.

Publication types

Case Reports