INTRODUCTION With a prevalence of 1-5 %, intracranial aneurysms are common. However, only 20-50 % of these aneurysms will rupture during a person's lifetime. This often happens spontaneously without exogenous factors. In the present study we reviewed the literature concerning the relation between trauma and rupture of a pre-existing aneurysm. METHODS All studies that reported a causal relation between trauma and rupture of a pre-existing aneurysm were included, irrespective of study design. They were limited though to those written in English or German. Excluded were studies with traumatic aneurysms, studies where the rupture of an aneurysm lead to trauma and studies with doubts about the order of events. RESULTS Thirteen studies with twenty-two cases of ruptured aneurysm in context with trauma and two unpublished cases were included. Fourteen patients were involved in a fight, seven patients in a bike/motorbike/bus accident and three got hit on the head in a setting outside of interpersonal violence. The aneurysm was located in internal carotid artery in most cases (7/24). The clear majority of patients (19/24) did not survive. CONCLUSION Arteries and aneurysms can rupture in context with head trauma although this is rarely the case. Patients after head trauma with typical blood pattern for aneurysmal SAH in the native CT scan should receive conventional angiography to exclude a vascular or aneurysmal rupture, even when CT-angiography is inconspicuous.

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钝性头部外伤患者颅内动脉瘤破裂的文献回顾

引言 颅内动脉瘤的患病率为 1-5%。然而，这些动脉瘤中只有 20-50% 会在人的一生中破裂。这通常是自发发生的，没有外因。在本研究中，我们回顾了有关创伤与预先存在的动脉瘤破裂之间关系的文献。方法 不论研究设计如何，所有报告创伤与预先存在的动脉瘤破裂之间存在因果关系的研究都被包括在内。但它们仅限于用英语或德语编写的那些。排除了创伤性动脉瘤的研究、动脉瘤破裂导致创伤的研究以及对事件顺序有疑问的研究。结果 纳入了 13 项研究，涉及 22 例与创伤相关的动脉瘤破裂病例和两例未发表的病例。14 名患者参与打架，7 名患者在自行车/摩托车/公共汽车事故中，3 名在人际暴力之外的环境中头部被击中。大多数情况下动脉瘤位于颈内动脉（7/24）。绝大多数患者（19/24）没有存活下来。结论 动脉和动脉瘤可能在头部外伤的情况下破裂，尽管这种情况很少发生。头部外伤后患者在本地 CT 扫描中具有典型的动脉瘤性 SAH 血型，应接受常规血管造影术以排除血管或动脉瘤破裂，即使 CT 血管造影术不明显。大多数情况下动脉瘤位于颈内动脉（7/24）。绝大多数患者（19/24）没有存活下来。结论 动脉和动脉瘤可能在头部外伤的情况下破裂，尽管这种情况很少发生。头部外伤后患者在本地 CT 扫描中具有典型的动脉瘤性 SAH 血型，应接受常规血管造影术以排除血管或动脉瘤破裂，即使 CT 血管造影术不明显。大多数情况下动脉瘤位于颈内动脉（7/24）。绝大多数患者（19/24）没有存活下来。结论 动脉和动脉瘤可能在头部外伤的情况下破裂，尽管这种情况很少发生。头部外伤后患者在本地 CT 扫描中具有典型的动脉瘤性 SAH 血型，应接受常规血管造影术以排除血管或动脉瘤破裂，即使 CT 血管造影术不明显。