Evidence map›Paper›PMID 40656504›Full record

ReviewSurgical neurology international2025

Distal intracranial artery pseudoaneurysm causing subdural hematoma: An illustrative case and a systematic review.

Kautilya R Patel, William E Thorell, Nicholas Borg, Daniel L Surdell, Uyen Tran, Cynthia M Schmidt, Sahara J Cathcart, Mithun G Sattur

Abstract readReview
In one paragraph

Review in Surgical neurology international, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Kautilya R PatelDepartment of Neurosurgery, University of Nebraska Medical Center, Clarkson Doctor's Building South, Omaha, Nebraska, United States.
William E ThorellDepartment of Neurosurgery, University of Nebraska Medical Center, Clarkson Doctor's Building South, Omaha, Nebraska, United States.
Nicholas BorgDepartment of Neurosurgery, University of Nebraska Medical Center, Clarkson Doctor's Building South, Omaha, Nebraska, United States.
Daniel L SurdellDepartment of Neurosurgery, University of Nebraska Medical Center, Clarkson Doctor's Building South, Omaha, Nebraska, United States.
Uyen TranSchool of Medicine, University of Nebraska Medical Center, Omaha, Nebraska, United States.
Cynthia M SchmidtMcGoogan Health Sciences Library, University of Nebraska Medical Center, McGoogan Library, Omaha, Nebraska, United States.
Sahara J CathcartDepartment of Pathology, Microbiology and Immunology, University of Nebraska Medical Center, Omaha, Nebraska, United States.
Mithun G SatturDepartment of Neurosurgery, University of Nebraska Medical Center, Clarkson Doctor's Building South, Omaha, Nebraska, United States.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Pseudoaneurysm arising from the distal segment of an intracranial artery is a rare cause of subdural hematoma (SDH). We report a patient diagnosed with a pseudoaneurysm of a cortical branch of the distal anterior cerebral artery (ACA) during planned middle meningeal artery embolization for SDH and present a systematic review to summarize the present literature. Methods: A systematic literature search was conducted across EMBASE, MEDLINE, CINAHL, the Cochrane Library, and Scopus to identify studies reporting SDH due to pseudoaneurysms in the terminal intracranial artery segments. Details regarding clinical presentation, management, and outcomes were extracted. Results: Twenty patients from the 18 retrospective studies and the patient from the present report were included in the review. The mean age of the patients was 49.4 years; 80.9% of the patients were males. A history of nonpenetrating head trauma was present in 11 (52.4%) patients. The most common presenting symptoms were hemiparesis and altered mental status. Catheter angiography established the diagnosis in the majority of the patients (85.7%). Angiography was performed due to a clinical/radiological suspicion for a pseudoaneurysm in 6 (28.5%) patients. In the majority of the patients (66.7%), angiography was performed for a different indication. Middle cerebral artery (15 patients, 71.4%) was the most common location of the pseudoaneurysm, followed by ACA, posterior cerebral artery, and posterior inferior cerebellar artery. Pseudoaneurysm was treated surgically in 14 patients (66.7%) and by endovascular modalities in 5 patients (23.8%). One patient undergoing endovascular treatment required surgical evacuation of SDH. The majority of the patients in both treatment groups (surgical - 72.7%, endovascular - 80%) recovered without severe disability (modified Rankin Scale ≤ 4). Conclusion: Pseudoaneurysms of distal segments of intracranial arteries are a very rare cause of SDH. A high index of suspicion is required for their identification. While a definitive diagnosis requires catheter angiography, indications to perform angiography in SDH are unclear. Pseudoaneurysms with SDH can be treated safely with both microsurgical and endovascular modalities. Microsurgery has the advantage of draining SDH at the same time. The relative efficacy of different treatment approaches and the indications for each are not yet defined.

Indexed as

EndovascularMicrosurgeryPseudoaneurysmSubdural hematomaTrauma

Identifiers

PMID40656504
PMCPMC12255207

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-SA
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.