Introduction
Case 1
Case 2
Case 3
Results
Author and year | Age | Trauma mechanism | Neurological symptoms | Vessel involved | Timing of TICA diagnosis (days) | SAH on initial scan | Was any negative vascular imaging performed? | Investigations that diagnosed TICA | Management | EVD initially for hydrocephalus or ICP management | Outcome | Complications |
---|---|---|---|---|---|---|---|---|---|---|---|---|
Hossain et al., 2002 [3] | 12 | Fall | Delayed acute drop in conscious level at day 19 due to hydrocephalus and day 21 due to rebleed | Right PICA | 21 | Yes | No (first CTA was at day 21 after rebleed) | CTA and then DSA at day 21 | Coiling | VP shunt as initially no IVH | Right arm weakness that improved. Wheelchair. No neuropsychological deficit. | Hydrocephalus requiring shunt |
Kneyber et al., 2005 [4] | ||||||||||||
Patient 1 | 5 | Fall | Acute drop in conscious level, recover and further drop in consciousness at day 7 | Basilar | 7 | Yes | No (first CTA was at day 7 after rebleed) | CTA at day 7 | Conservative | Yes | Severe neurological deficits | Stroke |
Patient 2 | 3 | Fall | Acute drop in conscious level | Right vertebral | 14 | Yes | No | MRA at day 14 | Surgical occlusion of vertebral | Yes | Severe neurological and neurophysiological deficits | Stroke |
Binning et al., 2009 [5] | 15 | Assault | Acute drop in conscious level | Left PICA | 21 months | Yes | Yes, initial CTA negative | Delayed CT and DSA at 21 months | Clipping and bypass | VP shunt | No new deficits | Hydrocephalus requiring shunt |
Kaplan et al., 1993 [6] | 41 | Post partum, presumed traumatic | Head and neck pain left arm and hand paraesthesia | Left vertebral (extracranial) | 28 | No (LP positive) | No | CTA and then DSA at 4 weeks | Balloon occlusion | No | No new deficits | No |
Schuster et al., 1999 [7] | ||||||||||||
Patient 1 | 22 | Assault | Acute drop in conscious level | Right PICA | 1 | Yes | No | DSA at day 1 | Clipping | Yes | Living independently with some memory difficulty at 1 year | Hydrocephalus requiring shunt, vasospasm requiring angioplasty |
Patient 2 | 16 | Hit with baseball | Acute drop in conscious level | Right PICA | 3 | Yes | Yes negative initial DSA, DSA at 72 hours positive | DSA at day 3, Day 1 DSA normal | Clipping | Yes | In assisted living placement at 6 months | Hydrocephalus requiring shunt, vasospasm requiring angioplasty |
Patient 3 | 33 | Fall | Acute drop in conscious level | Left PICA | 1 | Yes | No | DSA at day 1 | Clipping | Yes | In assisted living placement at 2 years | Hydrocephalus requiring shunt, vasospasm requiring angioplasty, DVT/PE |
Sure et al., 1999 [8] | 9 | Closed head trauma | Hydrocephalus needing EVD after head injury and then further severe headache 3 weeks after initial head injury due to rebleed | Left PICA | 21 | Yes | No | DSA and MRI at 3 weeks | Clipping (failed coil) | Yes | No deficits | Hydrocephalus requiring shunt |
Nishioka et al., 2002 [9] | ||||||||||||
Patient 1 | 20 | Direct head trauma during karate | Seizure and reduced consciousness with rebleeds at day 15 and 66 | Right PICA | 11 | Yes | No | DSA at day 11 | Too unstable for treatment | Yes | Death | Hydrocephalus and multiple rebleeds |
Patient 2 | 33 | Hit head on wall | Headache and nausea and then delayed acute drop in consciousness at day 14 due to rebleed | Left PICA | 1 | Yes | No | DSA at day 1 and day 14 | Clipping | No | No deficits | Rebleed, hydrocephalus requiring shunt |
Malek at al, 2000 [10] | 42 | Direct head trauma during kickboxing | Headache, cranial nerve palsies, meningism with acute drop in consciousness at day 6 | Left vertebral | 6 | Yes | No | DSA at day 6 | Coiling | No | No deficits | No |
Kim et al., 2014 [1] | 51 | Fall | Reduced consciousness with further deterioration in consciousness the same day secondary to rebleed | Basilar | 1 | Yes | No | CTA at day 1 | Coiling | No | Death | Rebleed, cerebral swelling |
Ong et al., 2010 [11] | 3 | Fall | Acute drop in consciousness at 2 weeks post injury | Left superior cerebellar artery | 14 | Yes | No | CTA and DSA at day 14 | Coiling | No | Death | _ |
O;Shaughnessy et al., 2005 [12] | 13 | Oral gunshot wound | Intact consciousness at presentation, VA injury found on imaging and treated endovascularly. Delayed deterioration in consciousness and headache at day 8 due to bleed from VA TICA | Left vertebral | 8 | At second presentation after TICA rupture on day 8 | No | DSA at day 1 (occlusion) and day 8 (TICA) | Clipping after bleed from new TICA post coiling | Yes | No deficits at 1 year | Hydrocephalus not needing permanent CSF diversion |
Cohen et al., 2010 [13] | 23 | Direct neck trauma during taekwondo | Acute drop in conscious level | Left vertebral | 1 | Yes | No | DSA at day 1 | Endovascular vessel occlusion | Yes | Mild dizziness and ataxia at 1 month | Hydrocephalus not needing permanent CSF diversion |
Coulter et al., 2011 [14] | 20 | Road traffic accident | Acute drop in conscious level | Right vertebral | 1 | Yes | No | DSA at day 1 | Endovascular vessel occlusion | No | No deficits | No |
Purgina et al., 2015 [15] | 22 | Assault | Loss of consciousness with improvement. Acute deterioration in consciousness at day 9 due to rebleed | Left PICA | 7 | Yes | Yes, day 1 DSA negative, CTA at day 7 positive | DSA at day 1 normal, CTA at day 7 small PICA aneurysm, DSA at day 9 enlarged PICA aneurysm | Too unstable for treatment | No | Death | Rebleed and hydrocephalus |
Morard & deTribolet, 1991 [16] | 31 | Fall | Acute drop in conscious level | Right PICA | 10 | Yes | No | DSA at day 10 | Clipping | Yes | Full recovery | Hydrocephalus requiring shunt |
Chiang et al., 2009 [17] | 50 | Assault | Acute drop in conscious level | Right vertebral | 1 | Yes | No | DSA at day 1 | Clipping | No | Full recovery | No |
Meguro et al., 1985 [18] | 54 | Road traffic accident | Quadriparesis and cranial nerve palsies | Right PICA | 6 | Yes | No | DSA at day 6 and day 33 | Surgical excision | No | Almost independent | No |
Quattrocchi et al., 1990 [19] | 26 | Assault (penetrating) | Acute drop in conscious level and then rebleed after EVD sited | Left superior cerebellar artery | 1 | Yes | No | DSA at day 1 | Too unstable for treatment | Yes | Death | Rebleed |
Bell et al., 2010 [20] | 24 | Penetrating neck injury | Acute drop in conscious level on day 4 post injury | Left PICA | 4 | Yes | Yes, initial CTA negative, DSA at day 4 and 7 positive | DSA at day 4 and at day 7 which showed enlargement | Coiling | Yes | Almost independent | No |
Present case 1 | 20 | Assault | Acute drop in conscious level | Right vertebral | 11 | Yes | Yes, CTA at presentation negative | Initial CTA negative, died before DSA | Too unstable for treatment | No | Death | Hydrocephalus and rebleed |
Present case 2 | 24 | Assault | Acute drop in conscious level | Left PICA | 1 | Yes | No | CTA and DSA at day 1 | Coiling and stenting | Yes | Almost independent | EVD related haematoma |
Present case 3 | 35 | Fall | Acute drop in conscious level, recovery and further drop in consciousness at day 7 due to rebleed | Left PICA | 7 | Yes | Yes negative initial CTA | Initial CTA negative, DSA at day 7 | Coiling | Yes | Death | Hydrocephalus, Shunt malfunction |