A foreign body that has been left for 20 years causes a pseudoaneurysm of the middle cerebral artery: a case report

J Med Case Rep. 2024 Feb 1;18(1):39. doi: 10.1186/s13256-023-04334-w.

Abstract

Background: We report a patient with extensive subarachnoid hemorrhage caused by the rupture of a middle cerebral artery pseudoaneurysm from a foreign body that had been left for two decades.

Case presentation: A 74-year-old male patient from Han nationality was admitted to the emergency department of our hospital with impaired consciousness for 1 hour. Cranial computed tomography examination indicated a massive subarachnoid hemorrhage with intraventricular blood accumulation, and a high-density short strip dense shadow was seen in the M1 segment of the right middle cerebral artery, considering the possibility of a foreign body. Subsequently, a cerebral angiography was suggested; the foreign body was seen through the right middle cerebral artery, and the aneurysm was seen in the lower wall, so a pseudoaneurysm was considered. The emergent surgical intervention involved the clipping of the pseudoaneurysm and intracranial extraction of the foreign body. Unfortunately,the patient ultimately expired due to severe pulmonary infection.

Conclusion: Intracranial pseudoaneurysm caused by foreign body has been rarely reported previously, and microsurgical treatment of an intracranial pseudoaneurysm caused by a foreign body is a good choice.

Keywords: Foreign object; Middle cerebral artery; Pseudoaneurysm; Subarachnoid hemorrage.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Aneurysm, False* / diagnostic imaging
  • Aneurysm, False* / etiology
  • Aneurysm, False* / surgery
  • Cerebral Angiography / adverse effects
  • Foreign Bodies* / complications
  • Foreign Bodies* / diagnostic imaging
  • Foreign Bodies* / surgery
  • Humans
  • Male
  • Middle Cerebral Artery / diagnostic imaging
  • Middle Cerebral Artery / surgery
  • Subarachnoid Hemorrhage / diagnostic imaging
  • Subarachnoid Hemorrhage / etiology
  • Subarachnoid Hemorrhage / surgery