Submandibular gland duct endoscopy. Diagnostic value for salivary duct disorders in comparison to conventional radiography, sialography, and ultrasonography

The purpose of this study is to evaluate the usefulness of endoscopy as a procedure for the diagnosis of submandibular gland duct disorders. Endoscopy of the submandibular glands was performed on 12 patients with symptoms of obstructive sialoadenitis to identify the cause of obstruction. The endoscopic findings were then compared to those of diagnostic procedures such as conventional radiography, sialography, and ultrasonography. Six normal subjects also underwent endoscopy to better understand the normal findings of the duct system. Endoscopy demonstrated salivary gland calculus in 5 of 12 patients, which was revealed as filling defects on sialograms and as strongly echogenic structures on ultrasonograms in 4 of the patients. Endoscopy revealed secretion plugs, secretion plaques, and/or stenosis, which could not be seen by any other diagnostic procedures in 5 patients, as the cause of recurrent swelling in all 7 patients not demonstrating sialolith. Abnormal findings of the duct wall such as vasodilatation, fibrosis, edema, or erythema were seen in four patients, three of whom exhibited dilatation of the duct system on sialograms. In four patients, a decreasing internal echo level of the gland was seen on ultrasonograms. Our initial results for submandibular gland duct endoscopy thus appear to be promising.

Analyses of the APC and TGF-beta type II receptor genes, and microsatellite instability in mucosal colorectal carcinomas

APC and transforming growth factor-beta type II receptor (TGF-beta RII) gene mutations, and microsatellite instability have been found in sporadic colorectal carcinomas. To clarify further the early alterations in colorectal carcinogenesis, we investigated these genetic changes in 23 protruding- and 24 superficial-type mucosal colorectal carcinomas. TGF-beta RII gene mutations and microsatellite instability were rarely found in these lesions. Nevertheless, APC was mutated in 16 of the 47 (34.0%) mucosal colorectal carcinomas and was significantly more frequently mutated in protruding- (I) and superficial elevated-type (IIa) (14/32, 43.8%) than in other superficial-type (IIa+IIc, IIb, IIc, and IIc+IIa) (2/ 15, 13.3%) mucosal colorectal carcinomas (P < 0.04). These results indicate that the APC gene may be involved from the beginning in the tumorigenesis of many early colorectal carcinomas, particularly of the protruding and superficial elevated types. However, there might be a distinct pathway for other superficial-type colorectal carcinomas, possibly not involving APC as an initial step of tumorigenesis.

Effect of electrochemically deposited apatite coating on bonding of bone to the HA-G-Ti composite and titanium

The surfaces of hydroxyapatite-glass-titanium (HA-G-Ti) functionally gradient composite and titanium bars were treated with electrochemical apatite deposition, and a cathodic current was applied at 62 degrees C in a solution containing calcium and phosphate ions. Specimens with and without the electrochemical surface treatment were implanted in the femurs of Japanese white rabbits. The rabbits were sacrificed at 3, 6, and 9 weeks after implantation, and the bonding strengths of bone to these specimens were determined by a pull-out method. At 3 and 6 weeks after implantation the specimens with the electrochemical surface treatment showed larger values for the Weibull modulus and characteristic strengths than those of untreated specimens, whereas there was no remarkable difference in the results at 9 weeks. Especially the pull-out strengths of surface-treated specimens were significantly larger than the untreated ones at 3 weeks after implantation. Scanning electron microscopy and Fourier transform infrared absorption spectroscopy of the specimen surface after implantation demonstrated that formation of new bone was enhanced by the electrochemical surface treatment. It can be concluded that the electrochemical surface treatment undoubtedly contributes to the early stage fixation between bone and implant.

[Evaluation of neuro-Behçet disease with 99mTc-HMPAO brain SPECT: comparison with MR imaging]

The purpose of this study was to evaluate the brain perfusion of neuro-Behçet disease using 99mTc-HMPAO. In total, nine patients (7 men and 2 women) were evaluated. Seven were in the chronic phase, one was acute and the other was subacute. The results of perfusion study were compared with the MRI findings. The findings of chronic-phase neuro-Behçet disease were as follows: 99mTc-HMPAO showed hypoperfusion of the cerebellum in 3, brain stem in 5, and cerebral cortex in 4 patients. Moreover, asymmetry of the basal ganglia and thalamus was seen in 4 cases with 99mTc-HMPAO. MRI showed atrophy of the cerebellum in 4, brain stem in 5 and cerebral cortex in 2 patients. One acute patient showed a perfusion defect with 99mTc-HMPAO that was consistent with the vasculitis shown with MRI. In the remaining subacute patient, perfusion defect was demonstrated with 99mTc-HMPAO, consistent with the infarction shown with MRI. It is concluded that brain perfusion scintigraphy is useful to evaluate the brain blood flow of neuro-Behçet disease.

Two-dimensional gray-scale clustering for texture analysis

OBJECTIVES

To develop a new quantitative method for the visual discrimination of image texture.

METHODS

Two kinds of image phantoms were prepared, one for evaluating the effects of change in size and gray values of individual pixels (primitives) on perceived coarseness and the other for evaluating changes in groups of pixels (clusters) on perceived heterogeneity. The phantom images were displayed on a CRT and presented to 11 observers who assessed heterogeneity and coarseness on a 10-point scale between -5 and +5. On the basis of the observers' results, a new texture analysis method termed two-dimensional gray-scale clustering analysis was developed and applied to measure quantitatively the texture of the phantoms. The results obtained were then compared with those of the visual evaluation.

RESULTS

The size of the primitives and the clusters greatly affected the visual evaluation of heterogeneity and coarseness. Changes in the gray value had only a slight effect. The intra-observer variation for heterogeneity was significantly larger than that for coarseness. Two-dimensional gray-scale clustering analysis could differentiate heterogeneity from coarseness. A high correlation was obtained between the visual evaluation and the quantitative data.

CONCLUSION

Quantitative two-dimensional gray-scale clustering analysis appears to be a useful means of texture analysis.

Malignant lymphoma in patients with rheumatic diseases other than Sjögren's syndrome: a clinicopathologic study of five cases and a review of the Japanese literature

We conducted clinicopathologic and immunohistochemical analysis of five patients with malignant lymphoma complicating rheumatic diseases other than Sjögren's syndrome, and reviewed 26 cases of similar lesions reported in the Japanese literature over a 17-year period. All five patients were women ranging in age from 31 to 74 years (mean 55 years). Two of them fulfilled the diagnostic criteria for systemic lupus erythematosus, two for dermatomyositis and one for progressive systemic sclerosis. The use of immunosuppressive drugs before the onset of malignant lymphoma was recorded in four patients. All the biopsied or resected specimens showed non-Hodgkin's lymphoma of B-cell phenotype. Three were nodal in origin (one diffuse mixed, one diffuse large cell and one immunoblastic) and two were extranodal (one low-grade B-cell lymphoma of mucosa-associated lymphoid tissue and one diffuse large cell). In three of four cases examined, Epstein-Barr virus-encoded small RNAs were identified in a small to large number of the lymphoma cells by in situ hybridization. Our study showed that the clinicopathological features of malignant lymphomas complicating rheumatic disease in Japan were similar to those in England and the USA. Furthermore, our findings suggested no evidence for a causative association between iatrogenic immunosuppression due to methotrexate therapy and the development of EBV-related lymphoid neoplasms.

Immunohistochemical localization of integrins and basement membrane components in colorectal epithelial tumors correlates with their histologic architecture

We studied the immunohistochemical localization of integrins (alpha2, alpha6) and basement membrane components (type IV collagen, laminin) in colorectal epithelial tumors (adenomas and adenocarcinomas) with respect to their intramucosal and invasive growth. The integrins showed two patterns of localization: basal polarization and diffuse expression. In intramucosal tumors, the basement membrane components were well preserved, and the staining intensity for the basal polarization of alpha6 increased with increasing size and grade of dysplasia of the tumors. In invasive adenocarcinomas, the basement membrane components were preserved, and the basal polarization of alpha6 was apparent in well-differentiated areas, while the tumor cells showed disorganization or loss of the basement membrane components and the diffuse expression of alpha6 with a reduction or loss of the basal polarization in moderately and poorly differentiated areas. The expression of alpha2 did not correlate with the grade of dysplasia of intramucosal tumors or the pattern of differentiation of invasive adenocarcinomas. These results suggest that the basal polarization of alpha6 and the preservation of the basement membrane components contribute to the glandular architecture of colorectal epithelial tumors, and that the diffuse expression of alpha6 with a reduction or loss of the basal polarization, and the disorganization and loss of the basement membrane components to the dispolarized affinity of tumor cells to the extracellular matrix.

Invasive potentials of gastric carcinoma cell lines: role of alpha 2 and alpha 6 integrins in invasion

The potentials of the two major histological types of gastric carcinoma to invade through extracellular matrices were studied with cell lines. We found that the invasive potential of intestinal-type carcinoma cells (MKN-28 and MKN-74) were higher than those of diffuse-type carcinoma cells (MKN-45 and KATO-III). To investigate whether the alpha 2 and alpha 6 integrin adhesion molecules are responsible for, or involved in carcinoma invasion. We further studied alpha 2 and alpha 6 expression patterns in these two types of cell line. Although fluorescence-activated cell sorting analysis revealed that all cells examined invariably expressed these integrin molecules, their expressional patterns were different among different cell lines. The intestinal-type carcinoma cells expressed integrins mainly along the cell-cell contact region, whereas the diffuse-type carcinoma cells showed a diffuse cytoplasmic pattern of integrin expression. Invasion by MKN-28, MKN-74 and MKN-45 cells through reconstituted basement membrane or type I collagen gel was significantly inhibited (P < 0.05) by 50 micrograms/ml anti-(alpha 2 integrin) or anti-(alpha 6 integrin) monoclonal antibodies. Our results suggest that active invasiveness is stronger in the intestinal-type than in the diffuse-type carcinoma cells and that alpha 2 and alpha 6 integrins play important roles in invasion of both types of gastric carcinoma cell lines.

[Three-dimensional images of hepatic tumors and hepatic vessels obtained by helical computed tomography]

Helical computed tomography was performed with intravenous contrast material administration in ten patients with hepatic tumors (metastatic tumor, n = 6; hepatocellular carcinoma, n = 4). Maximum intensity projection (MIP) images of intrahepatic portal venous branches and hepatic veins, and shaded surface display (SSD) images of the hepatic tumors were reconstructed for each patient. The MIP image and SSD image were fitted to overlap on a single display to obtain three-dimensional (3-D) images showing both the hepatic vessels and hepatic tumors. Subsegmental localization of the tumors determined from the 3-D images proved to be correct in all of the six patients who received hepatic resection after examination. 3-D images seem to be useful for preoperative assessment of hepatic tumors.

Metanephric adenoma of the kidney: ultrastructural, immunohistochemical and lectin histochemical studies

A case of metanephric adenoma, a rare benign tumor of the kidney is reported, and the results of ultrastructural, immunohistochemical, and lectin histochemical studies are presented. The patient was a 47 year old Japanese man presenting with a left renal tumor by ultrasonography. The nephrectomy material revealed a well-demarcated tumor with medullary appearance, and on histological examination the tumor was composed of cuboidal cells forming regular small tubules with hyalinous stroma. Incomplete glomeruloid structures were formed in a few elongated tubules composed of columnar cells. Metanephric blastema was not observed in the tumor or in the normal kidney. By electron microscope, the tumor cells were observed to be immature cells with microvilli at the apical surfaces. The neoplastic tubules were surrounded by basal lamina. The tumor cells were immunoreactive for Leu 7, epithelial membrane antigen, vimentin, and low molecular weight cytokeratin, and were weakly immunoreactive for S-100 protein. Peanut agglutinin, soybean agglutinin, and Dolichos biflorus agglutinin were bound to the apical surfaces of the tumor cells.

Effect of temperature on morphology of electrochemically-deposited calcium phosphates

Calcium phosphates were electrochemically deposited on titanium plates at temperatures from 4 degrees C to 92 degrees C in a solution of NaCl, K2HPO4 and CaCl2 x 2H20. Scanning electron microscopic studies showed that granular deposits formed on the electrode at electrolyte temperatures of 4 degrees C, 22 degrees C, and 37 degrees C; needle-like deposits formed at 52 degrees C-92 degrees C. The width and length of the needles increased with the temperature of the electrolyte. Based on the results of characterization by electron diffractometry. Fourier transform infrared spectroscopy and X-ray diffractometry, the granular deposits were identified as carbonate-containing calcium phosphate with low crystallinity, and the needle-like deposits as carbonate-containing apatite crystals elongated along the c-axis. Crystallinity of the deposits increased with the temperature of the electrolyte, whereas the orientation indices of the apatite increased with temperature up to 82 degrees C and slightly decreased at 92 degrees C.

[A pediatric case of cerebral infarction following minor head injury presenting interesting neuroradiological findings]

We reported a case of juvenile cerebral infarction following minor head injury. The patient, a 12-year-old girl, developed right hemiparesis and aphasia almost immediately after having fallen from about 1 meter height during the exercise class at school. CT and MRI study showed lacunar lesions bilaterally and almost symmetrically in the paraventricular deep white matter on both sides. A new stroke area, responsible for the symptoms, was recognized about 24 hours later on CT scan just next to the lacuna of the left side. Although angiography revealed a rare anomaly of the right side aortic arch, associated with subclavian steal phenomenon, presumably of congenital in nature, no abnormality was found in the intracranial vessels. She made a rapid recovery during her hospital stay and showed no more than a slight motor weakness in her right upper extremity on discharge. The literature was reviewed on the embryology of the aortic arch and brachiocephalic arteries. We speculate that the lacunar lesions found bilaterally are dilated large normal Virchow-Robin space, and the pathogenesis of the stroke in this patient was discussed.

[Autoradiographic study of myocardial fatty acid metabolism in diabetic mouse using 125I-BMIPP]

The existence of diabetic cardiomyopathy has been substantiated in patients with diabetes mellitus. In this study we evaluated two mice with diabetes mellites (DM) and two control mice to determine whether the fatty acid metabolism of the myocardium is abnormal when 125I-BMIPP is used. 125I-BMIPP of 0.74 MBq (20 microCi) was injected, and 30 min later, the mice were slaughtered. Heart, lungs, liver, spleen and kidneys were removed. After freezing the heart, myocardium was sliced into 20 micron sections using a cryostat. Each slice was placed in contact with an imaging plate for autoradiography. A bioimaging analyzer was used to analyze the data. The percent injected dose/g of heart was lower in the DM group than in the control group (11.6 +/- 0.49 vs 18.3 +/- 1.27). Each slice of the DM group also had fewer counts than slices in the control group (p < 0.05 or p < 0.01). These results indicated that fatty acid metabolism in the myocardium was less in the DM group than in the control group.

Crystal phase of fibrous calcium phosphates prepared with sodium alginate

This study investigated the effects of preparation conditions on the crystal phase of the fired fiber prepared with sodium alginate. Hydroxyapatite, Ca10(PO4)6(OH)2, hereafter referred to as HA, was only formed in fiber fired at 900 degrees C under proper conditions. There was no significant difference in the crystal phase of the fired fibers prepared using different sodium alginate concentrations and syringe nozzle diameter, although fiber diameters were enlarged with increasing in either. No effects of phosphate type on the crystal phase of the fired fiber were found, but the aging time and the rinsing time had great effects. Sodium calcium phosphate, NaCaPO4, and HA were formed when the aging time was shorter than 5 min. Chlorapatite, Ca5Cl(PO4)3, and HA were formed when the rinsing time was shorter than 3 sec, and HA was formed when the rinsing time was 5 min to 1 hour, beta-TCP, beta-Ca3 (PO4)2, and HA were formed when the rinsing time exceeded 2 weeks.

Effect of temperature on electrochemical deposition of calcium phosphate coatings in a simulated body fluid

Calcium phosphate coatings were deposited on titanium plate by an electrochemical method in simulated body fluid at 5-62 degrees C. X-ray diffractometry and FTIR studies demonstrated that the deposits at 5, 22 and 37 degrees C were amorphous and those at 52 and 62 degrees C contained Mg(OH)2, CaCO3 and carbonate apatite of low crystallinity. The calcium, magnesium and phosphorus contents of deposit increased in direct proportion to the square root of loading time of cathodic potential. Induction periods, which might be thought to be the time required to decrease the pH of the electrolyte around the cathode by the formation of H2 gas and to start deposition of calcium phosphate, were observed on all the regression lines. It is concluded that in the electrochemical synthesis of calcium phosphate in this temperature range the diffusion process is a rate-determining step.

Sjögren's syndrome with pleural effusion

Sjögren's syndrome (Sjs) can cause many organic changes, but is rarely accompanied by pleuritis. We report here a 62-year-old patient with subclinical Sjs who developed unilateral pleuritis with moderate effusion. He was diagnosed to have subclinical Sjs based on the positivity of anti SS-A/SS-B antibodies and the biopsy findings of minor salivary glands which revealed lymphocyte infiltration around the duct. In the pleural effusion, both increased lymphocytes and anti SS-A/SS-B antibodies were observed. He showed no signs of infection nor malignancy. There was no direct evidence that he had other collagen diseases which cause pleuritis. We conclude that the pleuritis was caused by Sjs. In patients with Sjs, activated polyclonal B lymphocytes and autoantibodies are considered to cause systemic tissue damage. This case indicates that these factors can cause pleuritis in Sjs patients.

[Leiomyosarcoma metastatizing to the sphenoid bone presenting exophthalmos: a case report]

A rare subcutaneous leiomyosarcoma metastatizing to the sphenoid bone and presenting exophthalmos is reported. A 56-year-old female presented with protrusion of the right eye and a slowly growing lump on the right temporal region. Six years previously, she had undergone removal of a subcutaneous mass in the back, which was histologically diagnosed in another hospital as leiomyosarcoma. She had undergone four other operations, including removal of local recurrences and a right renal metastasis. On admission, physical examination showed no neurological deficits. Craniogram revealed an osteolytic lesion without marginal sclerosis in the right sphenoid bone. CT showed an inhomogeneously enhanced mass with irregular expansion of the diploic space, which was partly invading the right orbit. MRI demonstrated an extradural mass in the right sphenoid region, which was slightly low-intense in T1-weighted image, high-intense in T2-weighted image, and inhomogeneously enhanced by Gd-DTPA. Right external carotid angiogram showed a highly vascular stain fed by meningeal arteries. Radionuclide bone scintigram showed multiple high-uptake areas in the left femoral head, the ribs, and the sphenoid bone. Preoperative embolization of the tumor vessels fed by the external carotid artery was performed. Following this procedure, the tumor stain disappeared completely. The tumor was totally excised with minimal bleeding through an orbitozygomatic approach. The tumor was loosely adherent to the dura and periorbit. The bone defect was covered with a methylmethacrylate resin plate. the histological examination demonstrated fascicular arrangement of the spindle shaped cells with mitotic figures. Immunohistochemical studies showed that most tumor cells were positive for actin and myosin, but negative for desmin.(ABSTRACT TRUNCATED AT 250 WORDS)

[Primary oculomotor nerve palsy due to head injury: analysis of 10 cases]

Ten cases of primary oculomotor nerve palsy due to head injury are presented. All ten patients had a dilated, non reactive pupil. Seven had complete oculomotor palsy. Two had partial extraocular palsy or blepharoptosis and one had neither extraocular palsy nor blepharoptosis. The initial ophthalmoplegia was recognized immediately after trauma. Nine patients had severely impaired consciousness on admission, but eight patients recovered fully within two months after the traumatic event, while one patient remained disoriented. Emergency CT scan on admission showed mass lesions in no patients except one who had a hematoma measuring 3 cm in the frontal lobe, but had no herniation sign. Patients with complete oculomotor palsy had a high incidence of traumatic SAH (71%) or skull fracture (57%). Recovery from third nerve palsy was not so good. The follow-up period extended from 3 months to 18 months. Of the 10 patients, none recovered completely from third nerve palsy. The prognoses of blepharoptosis, external ophthalmoplegia and internal ophthalmoplegia were analyzed separately. The recovery rates were 78%, 44% and 20%, respectively, the internal ophthalmoplegia showing poorest recovery. We discuss the mechanism of direct injury to the oculomotor nerve.

[A case of deep sylvian meningioma presenting temporal lobe epilepsy]

A rare case of deep sylvian meningioma is presented. A 62-year-old woman was admitted to our hospital because of one year history of temporal lobe epilepsy. She had no neurological deficit except for EEG abnormality. CT scans showed a small calcified mass in the left temporal lobe adjacent to the sylvian fissure with no enhancement by contrast medium. The mass was low-intense in both T1- and T2-weighted MR images. The T1-weighted image after the infusion of gadolinium revealed enhancement of the middle cerebral artery adjacent to the mass, similar to dural tail sign. Left external carotid angiography did not show any tumor stain nor the dilatation of the middle meningeal artery. Left internal carotid angiography disclosed enlarged middle cerebral artery without tumor stain. A left frontotemporal craniotomy was performed and the mass was totally removed. The tumor was located deep in sylvian fissure without any connection to the dura or ventricular system, which was firmly adherent to the middle cerebral artery. The histological examination of the surgical specimen revealed a psammomatous meningioma. Meningiomas are believed to originate from the arachnoid cap cells and can arise from various intracranial locations where arachnoid cap cells exist. The majority of them are attached to the dura, choroid plexus, or the tela choroidea. Only eleven cases of deep sylvian meningiomas have been presented in the literature. We have reviewed the clinical and radiological findings in such meningiomas. MR findings in deep sylvian meningioma have not been described.(ABSTRACT TRUNCATED AT 250 WORDS)

Effect of radiation and cigarette smoking on expression of FUdR-inducible common fragile sites in human peripheral lymphocytes

In vitro X-irradiation of human peripheral blood lymphocytes increased the frequencies of fluorodeoxyuridine-induced fragile sites in a dose-related manner. However, the cells from 30 atomic bomb survivors exposed to either high or low radiation doses 47 years earlier showed no demonstrable difference in fragile site expression, indicating that fragile site induction was ephemeral in nature. When fragile sites were analyzed on the basis of tobacco smoking habits, an elevated number was observed in the smokers. The results confirm that fragile sites can be affected by recent exposure to exogenous agents, but the effect is probably of limited duration, based on the atomic bomb survivor experience.

[Non-traumatic cerebrospinal fluid rhinorrhea associated with hydrocephalus: a case report]

We report an unusual case of non-traumatic cerebrospinal fluid rhinorrhea associated with aqueductal stenosis and hydrocephalus. The patient was a 10-year-old girl who suddenly developed massive CSF rhinorrhea following severe edema of the left side of her face. CT scan showed marked dilatation of the lateral and third ventricles and enlarged sphenoid sinus of water density, extending to the lateral wall of the left orbit and to the left pterygoid fossa. Immediately after the onset of CSF rhinorrhea, ventricular drainage was performed, but the rhinorrhea persisted. Ventriculography revealed predominant flow of the contrast medium into the left temporal horn and abnormal collection in the sphenoid sinus. Coronal CT scan did not show any focal bony defect, but a thin layer was seen in the base of the left middle fossa. Exploration of the skull base in the left middle fossa was performed through a left frontotemporal craniotomy. An irregular bony defect measuring 7 x 12mm was then found in the anterolateral floor of the middle fossa and the dura was also perforated there. Brain tissue including the temporal horn protruded through the bony defect into the sphenoid sinus. After excision of the herniated brain tissue, repair was accomplished by packing muscle into the bony defect and covering the dural defect with fat reinforced by coating with fibrin glue. Postoperatively, the CSF rhinorrhea has stopped and the edema of her face has disappeared. We discuss the etiology of this unusual spontaneous CSF leakage through the middle fossa and the abnormally enlarged sphenoid sinus.

Absorbed dose measurements and calculations in phantoms for 1.5 to 50 keV photons

A Monte Carlo code EGS4 expanded for low energy photon transport was validated by measuring absorbed doses in a phantom for 30 and 10 keV monoenergetic photons from synchrotron radiation. Using the EGS4 code, depth doses at 0.07 mm, 0.02 to 0.1 mm, and 10 mm in the ICRU slab phantoms were calculated for 1.5 to 50 keV photons using the updated photon cross section data PHOTX. The results show that the doses at 0.02 to 0.1 mm below 10 keV are practical indices of effective dose as calculated by others, based on the 1990 ICRP recommendations (1991).

[Traumatic anterior cerebral artery aneurysm difficult to distinguish from congenital cerebral aneurysm: case report]

We report the case of a 29-year-old woman in whom a saccular aneurysm of the distal anterior cerebral artery developed following head trauma due to a car accident. She was semicomatose on admission but had no lateralizing motor signs. Reflexes were symmetrical, with bilateral extensor toe sign. X-ray of the skull showed no fracture but CT scans demonstrated a large frontal hematoma and interhemispheric bleeding. Initial cerebral angiography performed within 12 hours of trauma showed a small protrusion on the pericallosal portion of the left pericallosal artery with no branching point nearby. Angiography was repeated on the 9th day after admission and confirmed the presence of a saccular aneurysm of the pericallosal artery, which had been visible as a small protrusion on the initial angiogram. Traumatic aneurysm was suspected and successful neck clipping of the aneurysm was performed on the 14th day. Preoperative CT and angiographic findings could not rule out a congenital aneurysm but the histological study of the specimen confirmed that it was a traumatic false aneurysm. We discussed the diagnosis and the etiology of posttraumatic aneurysm.