• Yu Shi, Yihang Sui, Kai Chen, Wenzhang Luo, Tianyu Zhang, Changren Huang, and Kunyang Bao.
• Department of Neurosurgery, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China.
• Medicine (Baltimore). 2023 Jun 9; 102 (23): e33974e33974.

RationaleDelayed rupture of traumatic intracranial aneurysms is relatively rare, and traumatic anterior A4 segment aneurysms may be associated with trauma to the cerebral falx. The mortality rate in patients with delayed traumatic rupture of intracranial aneurysms is>50%. Therefore, early diagnosis and treatment are critical. Herein, we present a case of a patient who did not have an intracranial aneurysm on computed tomographic angiography (CTA) after admission. Subsequently, the patient consciousness deteriorated, and CTA revealed aneurysm and bleeding.Patient ConcernsA 55-year-old man fell from a 3-meter-high truck and was unconscious. During the following few hours, the gradually regained consciousness. No intracranial aneurysms were found on CTA of the patient head immediately after admission.DiagnosesThe final diagnosis was delayed rupture of traumatic intracranial aneurysms.InterventionsThe patient underwent endovascular and symptomatic treatments.OutcomesThe patient gradually recovered and was referred to the rehabilitation department for further treatment.LessonsConsidering the catastrophic consequences of the disease, we should review CTA or digital subtraction angiography many times after admission, and take appropriate surgical procedures in time.Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.

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