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  • E-023 Delayed development of post-traumatic distal paracentral pericallosal artery branch pseudoaneurysm resulting in hematoma treated with emergent endovascular coiling and surgical evacuation: a case presentation

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SNIS 20th annual meeting electronic poster abstracts
E-023 Delayed development of post-traumatic distal paracentral pericallosal artery branch pseudoaneurysm resulting in hematoma treated with emergent endovascular coiling and surgical evacuation: a case presentation
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  1. M Koneru1,
  2. C Badger2,
  3. A Turtz1,2,
  4. H Shaikh1,2
  1. 1Cooper Medical School of Rowan University, Camden, NJ, USA
  2. 2Cooper University Health Care, Camden, NJ, USA

Abstract

A female patient in her 60s presented after a fall downstairs with normal level of consciousness. Initial computed tomography (CT) and computed tomographic angiography (CTA) demonstrated 3mm interhemispheric subdural hematoma with no vascular injury. After one week, she had sudden onset decreasing level of consciousness with aphasia. Follow up CT/CTA demonstrated new large left frontal intracerebral hemorrhage with intraventricular extension and a ruptured pseudoaneurysm of the left pericallosal artery. She was taken for cerebral angiogram with coil embolization of the pseudoaneurysm and distal parent artery followed by left frontal craniotomy with evacuation of the intracerebral hematoma. Subsequent laboratory tests and echocardiogram ruled out other vasculopathy or infectious causes.

This case demonstrates that pseudoaneurysm development and rupture can be a delayed complication of trauma. Although initial negative CTA is reassuring, there should be strong consideration for delayed follow-up CTA in trauma patients at risk of precipitating late-onset complications.

Abstract E-023 Figure 1
Abstract E-023 Figure 1

Disclosures M. Koneru: None. C. Badger: None. A. Turtz: None. H. Shaikh: None.

https://doi.org/10.1136/jnis-2023-SNIS.123

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