钝性面部损伤后创伤性颅内动脉瘤导致的延迟性大量鼻出血。
Delayed massive epistaxis from traumatic intracranial aneurysm after blunt facial injury.
作者信息
Nakamura Hajime, Fujinaka Toshiyuki, Tasaki Osamu, Yoshimine Toshiki
机构信息
Department of Neurosurgery Osaka University Graduate School of Medicine Osaka Japan.
Department of Neurosurgery Osaka National Hospital Osaka Japan.
出版信息
Acute Med Surg. 2016 Sep 4;4(1):131-134. doi: 10.1002/ams2.239. eCollection 2017 Jan.
CASES
Traumatic intracranial aneurysm following blunt head injury is uncommon but can be induced by extension of skull base fracture and causes unexpected hemorrhagic complications. We present two cases of traumatic intracranial aneurysm in the paraclinoid area that was revealed by delayed massive epistaxis. Lack of initial neurological deficits omitted screening for cerebrovascular injury.
OUTCOME
Internal trapping was carried out using endovascular techniques in both cases, with extracranial-intracranial bypass in one case. No recurrent bleeding occurred in either case.
CONCLUSION
To prevent unexpected delayed life-threatening hemorrhagic accidents, careful assessment of skull-base fracture is prerequisite, even in cases of mild facial injury.
病例
钝性头部损伤后创伤性颅内动脉瘤并不常见，但可由颅底骨折延伸诱发，并导致意外的出血性并发症。我们报告两例鞍旁区域创伤性颅内动脉瘤，表现为延迟性大量鼻出血。最初缺乏神经功能缺损症状导致未对脑血管损伤进行筛查。
结果
两例均采用血管内技术进行血管内封堵，其中一例进行了颅外-颅内搭桥术。两例均未再出血。
结论
为防止意外的延迟性危及生命的出血事故，即使在轻度面部损伤的情况下，仔细评估颅底骨折也是必要的。
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