Subarachnoid haemorrhage following rupture of an ophthalmic artery aneurysm presenting as traumatic brain injury

Head trauma may provoke subarachnoid haemorrhage. The question sometimes ar ises whether in patients with trauma and subarachnoid haemorrhage the latte r is of traumatic or aneurysmal origin. We present a 49-year-old patient wh o fell from a truck, struck his head and was unconscious immediately. On th e brain computed tomography (CT) scan subarachnoid haemorrhage was present, initially diagnosed as of traumatic origin. Four-vessel angiography reveal ed rupture of a left ophthalmic artery aneurysm. We review the literature a nd give recommendations for angiography in patients with trauma and subarac hnoid haemorrhage. (C) 2000 Elsevier Science B.V. All rights reserved.