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Traumatic Subarachnoid Hemorrhage Resulting from Posterior Communicating Artery Rupture
Traumatic subarachnoid hemorrhage (SAH), a common finding following head trauma, is usually a benign condition with a favorable outcome, seldom requiring surgical intervention. Unlike nontraumatic aneurysmal SAH, most cases of traumatic SAH occur in the sulci of the cerebral convexities, and only ra...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Dove
2020
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7326191/ https://www.ncbi.nlm.nih.gov/pubmed/32617022 http://dx.doi.org/10.2147/IMCRJ.S254160 |
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author | Kim, Jiha Lee, Seung Jin |
author_facet | Kim, Jiha Lee, Seung Jin |
author_sort | Kim, Jiha |
collection | PubMed |
description | Traumatic subarachnoid hemorrhage (SAH), a common finding following head trauma, is usually a benign condition with a favorable outcome, seldom requiring surgical intervention. Unlike nontraumatic aneurysmal SAH, most cases of traumatic SAH occur in the sulci of the cerebral convexities, and only rarely arise at the base of the brain. Basal traumatic SAH can be life-threatening and is primarily associated with rupture of vertebrobasilar arteries. We herein present a rare case of basal traumatic SAH resulting from rupture of the posterior communicating artery (PCoA). A 77-year-old male was taken to the emergency department in a semicomatose state. Upon arrival at emergency room, the patient had a Glasgow coma scale (GCS) score of 6 (E1M3V2), and the neurologic examination demonstrated no focal neurologic deficit. Although the trauma history was evident from abrasions and bruising on the face and chest, brain computed tomography (CT) demonstrated basal SAH, which is typical for nontraumatic aneurysmal SAH. Subsequent digital subtraction angiography (DSA) disclosed a traumatic rupture at the mid-portion of right PCoA and ongoing extravasation of contrast media. Despite emergent trapping of the right PCoA by endovascular surgery, the patient’s clinical condition only minimally improved. The patient remained bed-ridden with stuporous mentality and persistent hydrocephalus. To the best of our knowledge, this is the first reported case of basal traumatic SAH originating from rupture of the PCoA. This case demonstrates that a meticulous vascular workup is mandatory for every patient with basal SAH, even though a trauma history is clear. |
format | Online Article Text |
id | pubmed-7326191 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Dove |
record_format | MEDLINE/PubMed |
spelling | pubmed-73261912020-07-01 Traumatic Subarachnoid Hemorrhage Resulting from Posterior Communicating Artery Rupture Kim, Jiha Lee, Seung Jin Int Med Case Rep J Case Report Traumatic subarachnoid hemorrhage (SAH), a common finding following head trauma, is usually a benign condition with a favorable outcome, seldom requiring surgical intervention. Unlike nontraumatic aneurysmal SAH, most cases of traumatic SAH occur in the sulci of the cerebral convexities, and only rarely arise at the base of the brain. Basal traumatic SAH can be life-threatening and is primarily associated with rupture of vertebrobasilar arteries. We herein present a rare case of basal traumatic SAH resulting from rupture of the posterior communicating artery (PCoA). A 77-year-old male was taken to the emergency department in a semicomatose state. Upon arrival at emergency room, the patient had a Glasgow coma scale (GCS) score of 6 (E1M3V2), and the neurologic examination demonstrated no focal neurologic deficit. Although the trauma history was evident from abrasions and bruising on the face and chest, brain computed tomography (CT) demonstrated basal SAH, which is typical for nontraumatic aneurysmal SAH. Subsequent digital subtraction angiography (DSA) disclosed a traumatic rupture at the mid-portion of right PCoA and ongoing extravasation of contrast media. Despite emergent trapping of the right PCoA by endovascular surgery, the patient’s clinical condition only minimally improved. The patient remained bed-ridden with stuporous mentality and persistent hydrocephalus. To the best of our knowledge, this is the first reported case of basal traumatic SAH originating from rupture of the PCoA. This case demonstrates that a meticulous vascular workup is mandatory for every patient with basal SAH, even though a trauma history is clear. Dove 2020-06-26 /pmc/articles/PMC7326191/ /pubmed/32617022 http://dx.doi.org/10.2147/IMCRJ.S254160 Text en © 2020 Kim and Lee. http://creativecommons.org/licenses/by-nc/3.0/ This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php). |
spellingShingle | Case Report Kim, Jiha Lee, Seung Jin Traumatic Subarachnoid Hemorrhage Resulting from Posterior Communicating Artery Rupture |
title | Traumatic Subarachnoid Hemorrhage Resulting from Posterior Communicating Artery Rupture |
title_full | Traumatic Subarachnoid Hemorrhage Resulting from Posterior Communicating Artery Rupture |
title_fullStr | Traumatic Subarachnoid Hemorrhage Resulting from Posterior Communicating Artery Rupture |
title_full_unstemmed | Traumatic Subarachnoid Hemorrhage Resulting from Posterior Communicating Artery Rupture |
title_short | Traumatic Subarachnoid Hemorrhage Resulting from Posterior Communicating Artery Rupture |
title_sort | traumatic subarachnoid hemorrhage resulting from posterior communicating artery rupture |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7326191/ https://www.ncbi.nlm.nih.gov/pubmed/32617022 http://dx.doi.org/10.2147/IMCRJ.S254160 |
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