Abstract
We describe the case of a 57-year-old man who had traumatic subarachnoid hemorrhage (SAH) with a delayed growth of an ophthalmic artery aneurysm. Initially, computed tomography angiography did not show any evidence of aneurysmal dilatation, but digital subtraction angiography (DSA) after 3 days showed small aneurysmal dilatation or dissection of a presumed lesion. Early intervention or surgery was difficult because of the patient's unstable condition. The SAH was completely resolved within 7 days. Follow-up DSA was performed 2 weeks later and it revealed an increasing size and shape change. We treated the patient with coil embolization, partially filling the aneurysm to save the ophthalmic artery. DSA performed 6 months later indicated that the aneurysm was completely embolized, sparing the ophthalmic artery. In traumatic SAH, delayed growth of the aneurysm should always be considered, and follow-up imaging should be performed. Partial embolization to save the ophthalmic artery can be one of the treatment modalities for selected patients.
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