Traumatic Intracranial Aneurysm Formation following Closed Head Injury.

Background: Traumatic intracranial aneurysms are rare conditions that can be a result of non-penetrating head trauma. We report the occurrence of intracranial aneurysms in patients with traumatic brain injury.

Methods: All diagnostic cerebral angiograms performed in patients with traumatic brain injury at a level I trauma center from January 2006 to July 2007 were reviewed.

Results: Diagnostic cerebral angiography was performed in 74 patients with the diagnosis of closed head injury. A total of 4 traumatic intracranial pseudoaneurysms were found in 4 patients, two in the supraclinoid segment of the internal carotid artery, one in the cavernous segment of the internal carotid artery and one in the paraophthalmic segment of the internal carotid artery. Two patients were treated with coil embolization. One patient had follow up imaging on which there was no change in the size and morphology of the aneurysm.

Conclusion: Intracranial aneurysms can develop in patients with closed head injury presumably related to shear or rotational injury. It is unclear whether these aneurysms should be classified as traumatic intracranial aneurysms or pseudoaneurysms, but the pathological findings frequently reveal disruption of the three vascular layers fulfilling the definition of pseudoaneurysm. For these reason we favor the name of post-traumatic intracranial pseudoaneurysms.