Extravasation from an intracranial aneurysm during carotid angiography. Case report.

Abstract

A ~3-year-old auto mechanic was admi t ted at 1:30 a.m. on April ~4, 1966, following a single-car accident. In 1959, he had been hospitalized for cerebral concussion af ter a similar incident. Examination. A severe upper respiratory obstruct ion required immediate endotracheal intubation. The pupils were fixed and dilated. The optic fundi were normal. There were several bruises about the head and lacerations of the nose and chin. The pat ient responded to deep pain with nonpurposeful movements of all limbs. Deep tendon reflexes were absent, and there was no response when extensor toe signs were tested. X-rays of the skull, cervical spine, and chest were normal. Over the next few hours, the pat ient rapidly became more alert and removed his endotracheal tube. The pupils became reactive, small, and equal. He awoke sumcient ly to complain of severe headache. By 4:00 p.m. on the day of admission, the pat ient, al though still lethargic, could be easily aroused, and was oriented. Dur ing the following day he responded to voice, moved all extremities well, fed himself, and no longer complained of headache. Deep tendon reflexes were symmetrical and hypoact ive . Extensor toe signs could not be elicited. Three days later, the pa t ient again complained of headache, which was severe, dif-