Arterial injuries after penetrating brain injury in civilians: risk factors on admission head computed tomography

Abstract

The risk factors identified may help radiologists suggest the possibility of arterial injury and prioritize neurointerventional consultation and potential DSA studies.

Cerebrovascular complications of transorbital penetrating intracranial injuries

“…[10,17,[24][25][26] The most comprehensive studies on TIPI include a book by Van Duinen published in 2000 [10] and a thesis by Welman presented in 2004. [17] It is quite likely that TIPI cases are included in large series of penetrating cranial trauma, [12,27] but a distinct transorbital route is not defined in these large series. We went over the citations provided by Van Duinen [10] and Welman et al [17] to search for the traumatic aneurysms secondary to low-velocity TIPI, and then, we also searched the literature from 1999 to date to find additional cases of low velocity TIPVI.…”

Traumatic cerebrovascular injury: clinical characteristics and illustrative cases

“…The most common intracranial injury before TCVI was basilar skull fracture; maxillofacial and orbital injuries were found, respectively, in 14% and 13% of the 42 patients with TCVI. According to Bodanapally et al 4 and Biffl et al, 3 TCVIs are divided into 4 groups: stenosis/occlusion, pseudoaneurysm, AVF, and transection. 28 Characteristics of TCVI injuries are demonstrated in Table 2.…”

“…In 1999, Biffl et al 3 reported a grading scale for blunt carotid arterial injury, distinguishing 5 injury grades: grade I, "luminal irregularity or dissection with < 25% luminal narrowing"; grade II, dissection or intramural hematoma with ≥ 25% luminal narrowing, intraluminal thrombus, or raised intimal flap"; grade III, pseudoaneurysm; grade IV, occlusion; and grade V, "transection with free extravasation." Bodanapally et al, 4 in their 2015 article on arterial injuries after penetrating brain injury, described 4 types of intracranial arterial injury: traumatic intracranial aneurysm, dissection, occlusion, and carotidcavernous fistulas. In this current study, we stratified the types of TCVI into 4 groups: stenosis/occlusion, pseudoaneurysm, AVF, and transection.…”

“…Following Bodanapally et al 4 and Biffl et al, 3 TCVI was defined as intradural arterial injury from a primary force including blunt or penetrating injury and categorized into 4 groups: stenosis/occlusion; transection; pseudoaneurysm; and AVF. Cases of injuries to extracranial and extradural vessels were excluded, as were cases of cerebral infarction from secondary insults, such as a brain hypoxia.…”

Successful surgical treatment of a patient with combined gunshot shrapnel injuries in the heart and brain complicated by middle cerebral artery pseudoaneurysm

“…Advances in endovascular technology have provided an alternative to open surgical interventions in such pathologies. The most common endovascular methods include embolisation with coils, glue embolisation [10] or stenting [11]. …”