Pseudoaneurysms in a Penetrating Head and Neck Injury: a Case Series

Abstract

An intricate challenge faced by neurosurgeons involves the management of cerebral vessel Pseudoaneurysms. A comprehensive understanding of their natural progression, typical symptoms, underlying pathophysiology, and the diverse spectrum of available treatment modalities is crucial. This research focuses on three atypical cases of pseudoaneurysms resulting from penetrating head and neck injuries, diagnosed through Cerebral Catheter Angiography. The initial case involved a 14-year-old female with a metal bar penetrating the right maxillary region. A Left Frontal Craniotomy was performed, entailing the trapping of the Left Internal Frontal Artery. The second case featured an 11-year-old female with a frontal bone penetration by marble from a slingshot, necessitating a Bicoronal craniectomy and clipping of the left pericallosal Artery Pseudoaneurysm. The third case, involving a gunshot penetrating the posterior aspect of the neck with a slug at C1 lamina, was managed conservatively. Cerebral Angiography emerged as a pivotal method for detecting vascular pathology. Radiographic images depicting the pseudoaneurysm and the implicated foreign object are presented. The research strongly advocates for Digital Subtraction Angiography as the Gold Standard Diagnostic tool for pseudoaneurysms in the context of penetrating head and neck injuries. This recommendation is grounded in the method's superior diagnostic capabilities and its potential to enhance the precision of clinical assessments and subsequent therapeutic interventions.