Work-Related Head Trauma Induced Intracranial Aneurysm?

BACKGROUND: We report a possible unusual presentation of cerebral aneurysms from a head trauma in a patient who had been assessed for worker’s compensation following an incident of head trauma at work. There is some evidence that head trauma can be associated with cerebral aneurysm; however, our patient’s presentation was unique, without any previous signs or symptoms of intracranial aneurysms before the head trauma.
CASE REPORT: A 48-year-old African American woman working at a construction site was hit on the head by a 2×2 cm tile weighing about 30 pounds, which fell from a height of about 5 feet. She was initially treated for discomfort and pain, but after about 1 month of treatment and physical therapy without full recovery, a head MRI was done, which revealed 2 large cerebral aneurysms measuring 10 mm and 6mm at the distal right internal carotid artery, approximately at the level of the anterior clinoid process and at the region of the right internal carotid artery.
CONCLUSIONS: Workers’ compensation assessments require good clinical skills, follow-up, and high index of suspicion, not just for the immediate acute care, but also for the possibility of making a lifesaving diagnosis, as in this patient.

Keywords: Aneurysm, cerebral vessels, Occupational Medicine, head injuries