Aneurysmal subarachnoid hemorrhage in a patient with trauma (clinical case)

INTRODUCTION. Traumatic subarachnoid hemorrhage is common in brain injury and is associated with direct mechanical damage to cortical arteries and veins. Such hemorrhages are typically found on the convexital surface of the hemisphere. Cases of massive traumatic subarachnoid haemorrhage in the basal tanker area are more rare. In some of these patients, the cause of hemorrhaging is a ruptured cerebral aneurysm.

MATERIALS AND METHODS. Presented the clinical case of a 24-year-old patient who was treated in the Department of Neurosurgery of the Regional Clinical Hospital of Krasnoyarsk. The fracture of the jaw and rupture of the cerebral aneurysm in 2021. The article reviews scientific publications on cerebral aneurysm ruptures in patients with injury in databases Library and Pubmed for the period 2000-2023.

RESULTS. In the presented clinical observation in a patient who suffered an injury – a fracture of the jaw, a rupture of the communicative segment of the internal carotid artery was found. The patient had no primary cerebral complaints, which did not immediately raise concerns about a possible rupture of the aneurysm. Emergency surgical treatment – microsurgical clipping of aneurysm. There are similar observations in scientific publications, but none of them have been able to establish the primacy of injury or rupture of an aneurysm.

CONCLUSION. It is virtually impossible to prove conclusively that the patient suffered an injury or a rupture of a cerebral aneurysm. However, this is not a priority for practical work. The main thing is to diagnose a ruptured aneurysm in time, including in patients with a clear traumatic history, when subarachnoid hemorrhage is considered as a consequence of brain vascular trauma.

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