Journal Information
Vol. 27. Issue 2.
Pages 95-99 (March - April 2016)
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Vol. 27. Issue 2.
Pages 95-99 (March - April 2016)
Caso clínico
Aneurisma intracraneal traumático secundario a un trauma balístico. Caso clínico y revisión de la literatura
Traumatic intracranial aneurysm secondary to a bullet wound. Clinical case and a review of the literature
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Silvestre Emilio de la Rosa Morillaa,
Corresponding author
doctor_delarosa@hotmail.com

Autor para correspondencia.
, Anthony Melota, Sebastien Boissonneaua, Kaissar Faraha, Herve Brunelb, Pierre-Hugues Rochea
a Departamento de Neurocirugía, Centro Hospital Universitario Nord, APHM, Marsella, Francia
b Departamento de Radiología, Centro Hospital Universitario Nord, APHM, Marsella, Francia
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Resumen

Los aneurismas intracraneales traumáticos (AICT) son raros y están asociados con altas tasas de morbimortalidad. Los AICT son el resultado de lesiones en la cabeza causadas por accidentes, explosiones y disparos. Describimos el caso de un hombre de 28años que fue admitido en nuestro hospital después de sufrir una lesión craneal penetrante causada por una bala. Los estudios radiográficos demostraron una hemorragia subaracnoidea interhemisférica y una imagen probable de AICT que pasó inicialmente desapercibida. Una semana después se le realiza una arteriografía cerebral, la cual demuestra un vasoespasmo bilateral de la porción terminal de la arteria carótida interna (ACI) y la aparición de un AICT fusiforme de la rama orbitofrontal de la arteria cerebral anterior (ACA) de 2mm que fue tratado de manera quirúrgica tras un crecimiento del aneurisma de 3,4mm y un fallo del tratamiento endovascular. El paciente tuvo una evolución favorable en el postoperatorio.

Palabras clave:
Aneurisma intracraneal traumático
Hemorragia subaracnoidea
Vasoespasmo
Abstract

Traumatic intracranial aneurysms (AICT) are rare and are associated with high morbidity and mortality. AICT are the result of head injuries caused by accidents, explosions, and gunfire. The case is reported here of a 28 year old man who was admitted to our hospital after suffering a penetrating head injury caused by a bullet. Radiographic studies showed interhemispheric subarachnoid haemorrhage and a likely AICT image that initially went unnoticed. One week later he underwent a cerebral angiography which showed a bilateral vasospasm of the terminal portion of the internal carotid and the appearance of a 2mm fusiform AICT at the orbit-frontal branch of the anterior cerebral artery. This was surgically treated after an aneurismal growth of 3.4mm and failure of the endovascular treatment. The patient showed a favourable outcome after surgery.

Keywords:
Traumatic intracranial aneurysms
Subarachnoid haemorrhage
Vasospasm

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