D.V. Svistov, A.N. Savchuk, D.V. Kandyba, A.V. Shchegolev, V.Yu. Cherebillo, N.N. Voznesenskaya, P.Yu. Logunov
(Chair of Neurosurgery, Medicomilitary Academy, Saint Petersburg)
Patient N., aged 24, was transferred to the clinic on the 10th day after car injury.
He had severe open craniocerebral trauma, brain contusion with formation of contusion foci in basal segments of frontal lobes, massive traumatic subarachnoid hemorrhage, fractures of the skull fornix and base. The patient developed decompensated constrictive-stenotic artheriopathy (CSA) in carotid regions against a background of a state aggravation. Angiographic examination showed aneurysm of a supraclinoid segment of the right ICA. A double attempt to perform intravascular embolization of aneurysm failed. Ballonization and chemoangioplasty of the carotids, performed twice, were used. The patient was operated on January 30, 2002. A big false aneurysm of the ICA supraclinoid segment was diagnosed during the intervention; trapping was performed (D.V. Svistov, assistant professor). Control angiographic examination did not reveal aneurysm and was indicative of satisfactory collateral blood supply of the right carotid region through the anterior communicating artery.
The demonstration purpose was to present a rare complication of severe open craniocerebral trauma, i.e. traumatic aneurysm of the ICA inracranial segment, and to discuss diagnostic and therapeutic tactics in combined injuries of vessels in such a clinical entity, as craniocerebral trauma.