• World Neurosurg · Nov 2020

    Review Case Reports

    Diffuse Traumatic Sub Arachnoid Hemorrhage Mimicking Aneurysmal Bleeding Secondary to Ophthalmic Artery Avulsion: A Case Report and Literature Review.

    • Ahmed A Raslan, Ahmed B Abougamil, Mohamed Okasha, Milena Angelova-Chee, and Keyoumars Ashkan.
    • Department of Neurosurgery, King's College Hospital, NHS Foundation Trust, London, United Kingdom. Electronic address: raslanahmed87@gmail.com.
    • World Neurosurg. 2020 Nov 1; 143: 513-517.

    BackgroundTraumatic subarachnoid hemorrhage (SAH) is a common finding following traumatic brain injury. In some cases, it can be associated with hydrocephalus. This type of hemorrhage is mostly caused by the rupture of small vessels in the brain and is usually managed conservatively.Case DescriptionWe present a case of a 60-year-old woman who presented with traumatic luxation of the eye following a fall. This resulted in diffuse SAH (Fisher grade IV) with associated hydrocephalus. We also report on 3 previous similar cases found in the literature. Avulsion of the ophthalmic artery was found to be the cause of the traumatic SAH. Apart from cerebrospinal fluid diversion using an external ventricular drain, the case was managed conservatively. There was no evidence of delayed clinical or radiologic vasospasm.ConclusionsTraumatic avulsion of the ophthalmic artery may result in diffuse SAH, mimicking that of aneurysmal rupture. This case shows that management of early complications, such as hydrocephalus and seizures, should be the main aim. Surgical or endovascular treatment of the injured artery, however, would be unnecessary.Crown Copyright © 2020. Published by Elsevier Inc. All rights reserved.

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