Increased intracranial pressure without lateralizing signs: the midline syndrome

[Surgical treatment of a patient with a traumatic arterial aneurysm of the M4 segment of the left middle cerebral artery. Case report and literature review]

OBJECTIVE

The purpose of the study is to present the results of successful treatment of a patient with traumatic arterial aneurysm of the middle cerebral artery (MCA).

MATERIAL AND METHODS

A clinical case of traumatic arterial aneurysm of the M4 segment of MCA was studied. A patient with a ruptured traumatic aneurysm was transferred to Krasnogorsk City Hospital #1 for further examination and emergency surgery.

RESULTS

On the sixth day after surgery, the patient was discharged in a satisfactory condition with almost complete regression of neurological symptoms.

CONCLUSION

Treatment of traumatic arterial aneurysms requires an individual approach taking into account the past medical history, the clinical presentation, aneurysm location and anatomy, as well as the mechanism of injury. It is extremely difficult to suspect an arterial aneurysm after a patient had a traumatic brain injury as the incidence of this condition is very low. An angiographic study of cerebral vessels is needed for reliable diagnosis, not just solely performing standard computed tomography of the brain. Patients with this pathology require surgical intervention.