Traumatic aneurysm at the superior cerebellar artery: illustrative case

BACKGROUND Traumatic aneurysms at the superior cerebellar arteries after head injury are extremely rare and may be overlooked. Rupture of these aneurysms can cause fatal intracranial hemorrhages; thus, early identification of the entity helps prevent detrimental outcomes. OBSERVATIONS A patient suffered from sudden severe headache and decreased consciousness level several weeks after a blunt head injury. He received surgery to remove a progressive enlarging subdural hematoma. The diagnosis of a traumatic aneurysm at the superior cerebellar artery was delayed, made only after a recurrent subdural hemorrhage occurred. He received another surgery to obliterate the aneurysm. LESSONS The patient could have been treated earlier if traumatic aneurysm had been suspected in the beginning. In addition to the case, the authors also reviewed the literature to clarify the pathophysiology, clinical presentation, diagnosis, and management of the disease.

Treating traumatic aneurysm of a subclavian artery (a clinical case)

During repair of the rupture of the acromio-clavicular articulation (with a pin), artery subclavia dextra was damaged. This caused the formation of an artrerial aneurysm. Removal of the pin from the artery caused a progression of the arterial aneurysm. Revision without ultrasound caused arterial bleeding.

Ultrasound Diagnosis and Minimally Invasive Treatment of Posttraumatic Hematomas of the Spleen

The work presents the analysis of ultrasound diagnostic of traumatic hematomas of the spleen in 12 patients after blunt abdominal trauma. Traumatic injuries of large (4 patients) and giant (5 patients) sizes prevailed. Only 3 patients had medium sized traumatic lesion. Ultrasound examination was performed for all patients as a primary procedure and for dynamic observation. We tracked evolution of traumatic spleen injuries and identified four stages of pathological process in case of aseptic development: the stage of “fresh hemorrhage”, the stage of “formed clot”, the stage of “aseptic lysis of the clot”, the stage of “connective tissue organization”. We determined the evidence of pyogenesis of spleen hematomas, identified the stage “bacterial lysis of the clot” and stage of “forming capsules”. We determined the indications and contraindications for the minimally invasive treatment of spleen hematoma. Percutaneous evacuation of the spleen hematoma was performed in all patients. In four cases of minimally invasive treatment was puncture. In one patient the treatment was completed with a single puncture, in 3 patients – with a double one. Drainage of spleen hematomas was performed in 8 patients. We analyzed the results of minimally invasive treatment of traumatic injuries of the spleen under ultrasound control. Minimally invasive treatment was successful in 11 patients. Only 1 patient was operated for post-traumatic aneurysm of the splenic artery due to the continuing bleeding into hematoma.