# Traumatic vertebrobasilar pseudoaneurysms: diagnostic pitfalls on CT angiography with forensic implications — two case reports

## TL;DR

This paper discusses rare traumatic pseudoaneurysms in the vertebrobasilar artery that can be missed on standard CT scans, leading to diagnostic and legal issues.

## Contribution

The study highlights the importance of optimized thin-slice CTA in detecting traumatic pseudoaneurysms missed by standard imaging.

## Key findings

- Two cases of fatal traumatic subarachnoid hemorrhage revealed pseudoaneurysms confirmed by histopathology.
- Optimized thin-slice CTA successfully identified pseudoaneurysms missed by standard CTA.
- Diagnostic and medicolegal errors can occur due to technical limitations and low clinical suspicion.

## Abstract

Traumatic pseudoaneurysms of the vertebrobasilar artery are rare and may occur without skull fractures. Standard CTA may miss or misinterpret these lesions due to technical limitations and low clinical suspicion, leading to significant diagnostic and medicolegal errors; We present two cases of fatal isolated traumatic subarachnoid hemorrhage (iTSAH), where optimized thin-slice CTA, identified pseudoaneurysms of the PICA and VA (V4 segment), confirmed by histopathology.