Staged Trapping of Traumatic Basilar Trunk Pseudoaneurysm: Case Report and Review of Literature

Sujijantarat, Nanthiya; Pierson, M; Kemp, Joanna; Coppens, Jeroen

doi:10.1016/j.wneu.2017.08.144

Cited by 7 publications

(8 citation statements)

References 35 publications

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“…al., 2016 [ 19 ] F 55 Fall 3 Coma SAH Sixth nerve palsy \ Negative 1 month Right PICA Surgery Good Sujijantarat et. al., 2017 [ 45 ] M 14 Motorcycle accident 6 Coma SAH \ \ Pseudo-aneurysm \ SCA Surgery Vegetative Sami et. al., 2018 [ 41 ] F 24 Motorcycle accident 14 Loss of vision in the right eye \ \ \ Pseudo-aneurysm \ Right PCA Endovascular Good Ciochon et.…”

Section: Resultsmentioning

confidence: 99%

Post-traumatic intracranial pseudo-aneurysms of posterior circulation: a comprehensive review of an under-diagnosed and rare entity

et al. 2021

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Traumatic aneurysms are rare and the total number of cases involving the posterior circulation (TIPC) is even smaller. Traumatic brain injury (TBI) may be responsible not only of rupture in brain aneurysm (BrA) pre-existing to trauma, but it has been identified also as a possible pathogenetic cause of TIPC formation in patients not affected by intracranial vascular lesions. A complete literature review was performed of all reported cases regarding rupture of BrA with SAH resulting from TIPC not previously identified at the first radiological screening. A representative case of a left posterior inferior cerebellar artery (PICA) pseudo-aneurysm caused by left vertebral artery’s dissection is reported. We show a unique complete collection of all 34 cases. Despite their rarity, TIPCs are associated with a significant morbidity and mortality rate, as high as 40–60%. Of the 22 patients with good neurological status (64.7%), we did not notice a significant correlation with regard to the location of the aneurysm, type of treatment, or clinical onset. Early recognition of a pseudo-aneurysm and adequate treatment seem to be the most important prognostic factor for these patients. Despite their rarity, TIPCs are associated with a significant morbidity and mortality rate. A TIPC should be suspected in case of delayed deterioration in head‐injured patient and should be investigated with angiography. Conservative management is worsened by poor prognosis and the goal of treatment is to exclude the aneurysm from circulation with surgical or endovascular methods as soon as possible.

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Section: Resultsmentioning

confidence: 99%

Post-traumatic intracranial pseudo-aneurysms of posterior circulation: a comprehensive review of an under-diagnosed and rare entity

et al. 2021

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“… 4 , 6 , 7 , 10 DAPT can be safely used despite the presence of hemorrhage. 2 We argue that flow diversion for these traditionally challenging and aggressive lesions represents a viable treatment option in carefully selected patients with an acceptable risk-benefit profile, 4 , 6 , 7 , 10 and this report adds to the existing literature supporting the use of flow diversion therapy in the setting of acutely ruptured iatrogenic IPs. 6 , 7 …”

Section: Discussionmentioning

confidence: 73%

“…Endovascular intervention, particularly with flow diverters, has altered the management algorithm from vessel sacrifice with or without bypass to vessel reconstruction. 2 , 4 - 7 The use of the PED in the setting of acute hemorrhage is off-label and remains controversial because of the requirement for extended DAPT regimens. 4 - 7 In our case, microsurgical exclusion of the IP and bypass were ruled out because of the extensive postsurgical and postradiation changes in the operative field.…”

Section: Discussionmentioning

confidence: 99%

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Iatrogenic Middle Cerebral Artery Ruptured Pseudoaneurysm Successfully Treated With a Pipeline Embolization Device

Scullen

Mathkour

Carr

et al. 2021

TOJ

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Background: Endovascular advances have shifted the treatment algorithms for traumatic intracranial pseudoaneurysms (IPs) from vessel sacrifice to reconstruction. The Pipeline embolization device (PED) is a flow-diverting stent that promotes endothelialization across the lesion and reconstitutes the parent vessel lumen. Case Report: A 66-year-old male with a history of a right orbital apex lesion presented for biopsy with ophthalmology. Ophthalmology performed a right lateral orbitotomy complicated by brisk arterial bleeding from a proximal right middle cerebral artery (MCA) pseudoaneurysm. The MCA pseudoaneurysm was treated endovascularly with a PED, resulting in immediate stasis of contrast within the lesion without compilation. Interval follow-up angiograms 6 weeks and 6 months after the procedure showed no evidence of recurrence and a widely patent stent. Conclusion: The PED provided a rapid, minimally invasive, and durable treatment option for an acutely ruptured IP. We illustrate that endovascular management with flow diversion can be effectively used in select cases and provides a way to reconstruct the damaged vessel lumen and obliterate the aneurysm.

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“…[ 1 , 5 , 23 ] pTICAs in posterior circulation involving the basilar artery (BA) following severe head trauma have been rarely reported. [ 4 , 6 , 8 , 13 , 16 , 19 , 20 ] Furthermore, none of these reported pTICAs involved the anterior circulation. In this report, we describe a pediatric case of traumatic BA pseudoaneurysm accompanied by bilateral traumatic internal carotid artery (ICA) stenosis following blunt head trauma.…”

Section: Introductionmentioning

confidence: 99%

Repeated coil embolization of traumatic basilar artery pseudoaneurysm accompanied by bilateral traumatic internal carotid artery stenosis following severe head injury in a pediatric patient: A case report and literature review

Takeda¹,

Oda²,

Fukumoto³

et al. 2023

Surgical Neurology International

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Background: Few cases of pediatric traumatic intracranial aneurysms (pTICAs) in the posterior circulation involving the basilar artery (BA) following severe head trauma have been reported. Here, we describe a pediatric case of traumatic BA pseudoaneurysm accompanied by bilateral traumatic internal carotid artery (ICA) stenosis following blunt head trauma. Case Description: A 16-year-old boy presented to our emergency department after being hit by a car. The patient was initially diagnosed with multiple skull base fractures underlying traumatic subarachnoid hemorrhage and left acute epidural hematoma. Seven days following emergency craniectomy, magnetic resonance imaging revealed bilateral ICA stenosis, BA stenosis, and BA pseudoaneurysm. We decided to perform coil embolization, resulting in body filling and a volume embolization ratio of 15.7%. Twenty-eight days after coil embolization, digital subtraction angiography revealed aneurysmal rupture. We performed repeated coil embolization, resulting in body filling and a volume embolization ratio of 20.9%. Conclusion: We reported a pediatric case of traumatic BA pseudoaneurysm accompanied by bilateral traumatic ICA stenosis following a severe head injury treated with repeated coil embolization. Considering the risk of further brain injury due to high incidence of rupture, early vascular survey and appropriate treatment may be the most important prognostic factors in pTICAs.

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Staged Trapping of Traumatic Basilar Trunk Pseudoaneurysm: Case Report and Review of Literature

Cited by 7 publications

References 35 publications

Post-traumatic intracranial pseudo-aneurysms of posterior circulation: a comprehensive review of an under-diagnosed and rare entity

Post-traumatic intracranial pseudo-aneurysms of posterior circulation: a comprehensive review of an under-diagnosed and rare entity

Iatrogenic Middle Cerebral Artery Ruptured Pseudoaneurysm Successfully Treated With a Pipeline Embolization Device

Repeated coil embolization of traumatic basilar artery pseudoaneurysm accompanied by bilateral traumatic internal carotid artery stenosis following severe head injury in a pediatric patient: A case report and literature review

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