False Cortical Aneurysm in Subdural Haematoma following Head Injury without Fracture

Subdural haematomas following cranial injuries are usually caused by haemorrhage from convexity veins lying close to the large venous sinuses. Posttraumatic arterial subdural haematomas, on the other hand, are uncommon. DRAKE (1961) reported, however, that in a material of 100 cases with a subdural haematoma the bleeding was arterial in 11 cases following a lesion of a superficial cortical artery. A somewhat lower frequency was given by VANCE (1950), who stated that 6 of 102 subdural haematomas were due to arterial haemorrhage from cortical arteries; the cause of these subdural haemorrhages was discovered at operation. This arterial trauma may give rise to a false aneurysm; the origin of the subdural haemorrhage may then be determined preoperatively by angiography. Cortical aneurysms, occurring after injury to the skull without fracture and producing subdural haematomas diagnosed preoperatively by angiography, have been described by BASSETT & LEMMEN (1952) (one case), HIRSCH et call. (1962) (2 cases), SMITH & KEMPE (1970) (one case) and RUMBAUGH et call. (1970) (2 cases). SADIK et call. (1963) have described a case of subdural haematoma caused by rupture of a cortical aneurysm of a peripheral branch