Endovascular treatment and radiographic follow-up of proximal traumatic intracranial aneurysms in adolescents: case series and review of the literature

Abstract

Traumatic intracranial aneurysms at the skull base can be successfully treated with endovascular methods; however, close follow-up is necessary.

Cerebrovascular complications of transorbital penetrating intracranial injuries

“…Surgical and endovascular treatments and in selected cases, conservative management have been utilized. [19,39,40] We managed one aneurysm conservatively because the patient was not compliant with her medications including antiplatelet drugs. Selective coiling had failed and the tiny cavernous aneurysm had diminished in size during follow-up.…”

Rapid ventricular pacing for a basilar artery pseudoaneurysm in a pediatric patient: case report

“…1 The growth of traumatic intracranial aneurysms is unpredictable; therefore, additional imaging is essential in deciding when to treat this lesion. 3 Our patient was diagnosed with a basilar artery pseudoaneurysm measuring 4 × 2 mm on initial imaging that grew to 21 × 17 mm 32 weeks later. The reported time to hemorrhage of traumatic aneurysms from the time of initial trauma is 21 days and carries a mortality rate as high as 50%.…”

“…The reported time to hemorrhage of traumatic aneurysms from the time of initial trauma is 21 days and carries a mortality rate as high as 50%. 3,6 Due to the significant increase in growth, treatment became a priority.…”

“…2,3,[6][7][8][9]12 In the pediatric population and traumatic aneurysms, arguments supporting clip ligation include that it represents definitive treatment of the aneurysm, allows for reconstruction of the parent vessel, and alleviates mass effect of the aneurysm by thrombectomy. 4,6 We chose open surgery for these very reasons.…”

“…Since the development of Guglielmi coils, there are reports of treating traumatic intracranial aneurysms using endovascular techniques. 3,7,9,12 There is, however, a risk of recurrence, necessitating retreatment multiple times. 3,12 Given the large size of the aneurysm, history of trauma resulting in significant scarring, and the importance of preserving small but crucial pontine perforating vessels, safe dissection of the aneurysm was imperative.…”