Delayed intracerebral hematoma caused by traumatic intracavernous aneurysm : case report. Comments

Although delayed intracerebral hematomas from head injury are not uncommon, they are extremely rare when they are caused by extradural (extracranial) pseudoaneurysms of the internal carotid artery in the cavernous sinus. The case of a 33-year-old man who sustained a delayed frontal intracerebral hematoma from a traumatic intracavernous aneurysm 32 days after a head injury is presented. Posterior frontal base fractures accounted for monocular blindness and injury over the anterior siphon of the intracavernous carotid artery, which resulted in the formation of a pseudoaneurysm inside the sphenoid sinus. Subsequently, the cranial base fractures with secondary defects provided a route for the pseudoaneurysm to rupture intracranially and also accounted for intractable cerebrospinal fluid rhinorrhea and pneumocephalus after surgical treatment for the pseudoaneurysm and the intracerebral hematoma