Blunt traumatic superior gluteal artery pseudoaneurysm presenting as gluteal hematoma without bony injury: A rare case report / 中华创伤杂志(英文版)

Blunt traumatic injuries to the superior gluteal artery are rare in clinic. A majority of injuries present as aneurysms following penetrating trauma, fracture pelvis or posterior dislocation of the hip joint. We reported a rare case of superior gluteal artery pseudoaneurysm following blunt trauma presenting as large expanding right gluteal hematoma without any bony injury. The gluteal hematoma was suspected clinically, confirmed by ultrasound and the arterial injury was diagnosed by CT angiography that revealed a large right gluteal hematoma with a focal contrast leakage forming a pseudoaneurysm within the hematoma. Pseudoaneurysm arose from the superior gluteal branch of right internal iliac artery, which was successfully angioembolized. The patient was discharged on day 4 of hospitalization with resolving gluteal hematoma. This report highlighted the importance of considering an arterial injury following blunt trauma to the buttocks with subsequent painful swelling. Acknowledgment of this rare injury pattern was necessary to facilitate rapid diagnosis and appropriate treatment.

Contralateral stroke with rapid recovery in a patient of herpes zoster ophthalmicus

Herpes zoster ophthalmicus commonly presents with vesicular eruptions of skin along a dermatome and post herpetic neuralgia. Viral invasion into the intracranial vessel and resultant arteritis is rare complication, reported mainly in elderly, children and immunocompromised individuals. We report a young immunocompetent male who reported to us with acute right sided hemiparesis following an episode of left sided herpes zoster ophthalmicus three months prior to stroke. Patient had a near complete recovery of his weakness without any treatment with persistent mild dysarthria. Magnetic resonance imaging of brain showed subacute infarct in left middle cerebral artery territory. Magnetic resonance angiogram demonstrated marked narrowing of the proximal segment of left middle cerebral artery. This case highlights herpes zoster ophthalmicus as one of the causes of stroke in young with good prognosis.