Traumatic Pseudoaneurysm of the Distal Anterior Cerebral Artery Following Penetrating Brain Injury Caused by a Crossbow Bolt: A Case Report
Abstract
Traumatic intracranial aneurysms are one possible complication after penetrating brain injury. A 25-year-old man with a history of major depression presented with a crossbow bolt penetrating the head. On arrival, Glasgow Coma Scale score was E4V5M6, with no apparent neurological deficit. Computed tomography (CT) of the head showed the crossbow bolt passing near the corpus callosum, with surrounding contusion. Three-dimensional rotational angiography showed no anterior cerebral artery injuries. The crossbow bolt was removed after bifrontal craniotomy, with no postoperative infection. Postoperative CT angiography (CTA) was repeatedly performed, and a 4 mm aneurysm was observed at the pericallosal artery-right posterior internal frontal artery (PIFA) bifurcation on postoperative day (POD) 35. Trapping and the right PIFA-left cortical branch side-to-side bypass were performed on POD38. A resected specimen confirmed a pathological diagnosis of pseudoaneurysm. The patient did not show any neurological deficit or cognitive dysfunction as of 8 months after admission. Traumatic anterior cerebral artery aneurysm might have formed due to proximity to the falx cerebri. As pseudoaneurysm was detected 4 weeks after trauma in our patient, follow-up CTA or digital subtraction angiography should be performed until at least 4 weeks after injury. In addition, neck clipping is occasionally unfeasible to treat traumatic pseudoaneurysm surgically, and a surgical strategy including bypass…
How strong is the evidence?
Evidence Hub reads this as a case report, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
Read the paper
Related studies
- Challenges and opportunities with drug repurposing: finding strategies to find alternative uses of therapeutics
- Challenges in Chagas Disease Drug Development
- T Cell Specificity: A Great Challenge in Chagas Disease
- Benznidazole treatment leads to DNA damage in Trypanosoma cruzi and the persistence of rare widely dispersed non-replicative amastigotes in mice
- Rapid Molecular Detection of Terbinafine-resistant Dermatophytes
- Identifying novel drugs with new modes of action for neglected tropical fungal skin diseases (fungal skinNTDs) using an Open Source Drug discovery approach
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.