Document Detail

Results of endovascular treatment of traumatic intracranial aneurysms.
MedLine Citation:
PMID:  18812959     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To present results of early angiographic diagnosis and endovascular treatment of traumatic intracranial aneurysms (TICA). METHODS: From June 2002 to December 2006, diagnostic angiography was performed on patients with moderate to severe traumatic brain injury that involved a cranial base fracture or a penetrating brain injury with a tract from the penetrating agent that entered at the pterional area, went through the middle cerebral artery candelabra, and crossed the midline. TICAs were treated by various endovascular techniques during the same angiographic procedure. RESULTS: Thirty-four patients with traumatic brain injury underwent angiography (25 penetrating brain injuries, nine blunt injuries); 13 TICAs were diagnosed (10 penetrating brain injuries, three blunt injuries). The Glasgow Coma Scale score at diagnosis ranged from 5 to 15. Angiography was performed for screening in eight patients and for clinical indications in five patients; 11 TICAs were diagnosed before rupture. Seven aneurysms were located on branches of the middle cerebral artery, two on pericallosal branches of the anterior cerebral artery, and four on the internal carotid artery. No recanalization was detected in 12 patients. One patient treated with a bare stent and coiling had a growing intracavernous pseudoaneurysm; therefore, internal carotid artery occlusion with extracranial-intracranial microvascular bypass was performed. Six patients refused angiographic follow-up, but computed tomographic angiography has failed to show recanalization. No patient presented with delayed bleeding (mean follow-up, 2.6 yr). There were no procedure-related complications or mortality. CONCLUSION: Early angiographic diagnosis with immediate endovascular treatment provided an effective approach for TICA detection and management. Endovascular therapy is versatile and offers a valuable alternative to surgery, allowing early aneurysm exclusion with excellent results.
José E Cohen; John M Gomori; Ricardo Segal; Alex Spivak; Emil Margolin; Gil Sviri; Gustavo Rajz; Shifra Fraifeld; Sergey Spektor
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Publication Detail:
Type:  Case Reports; Comparative Study; Journal Article    
Journal Detail:
Title:  Neurosurgery     Volume:  63     ISSN:  1524-4040     ISO Abbreviation:  Neurosurgery     Publication Date:  2008 Sep 
Date Detail:
Created Date:  2008-09-24     Completed Date:  2009-05-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7802914     Medline TA:  Neurosurgery     Country:  United States    
Other Details:
Languages:  eng     Pagination:  476-85; discussion 485-6     Citation Subset:  IM    
Department of Neurosurgery, Hadassah-Hebrew University Hospital, Jerusalem, Israel.
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MeSH Terms
Balloon Dilatation / methods*
Brain Injuries / complications,  radiography,  therapy*
Child, Preschool
Embolization, Therapeutic / methods*
Intracranial Aneurysm / etiology,  radiography,  therapy*
Prospective Studies
Tomography, X-Ray Computed / methods
Treatment Outcome
Young Adult

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