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 ORIGINAL ARTICLE
Year : 2018  |  Volume : 66  |  Issue : 1  |  Page : 105--114

Treatment strategies for traumatic cervico-cranial pseudoaneurysms: A single institution experience


1 Department of Neurosurgery, Wuhan General Hospital, Guangzhou Military Command of People's Liberation Army, Wuhan, PR China
2 Department of Interventional Neuroradiology, Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, Beijing, PR China
3 School of Mathematics and Statistics, Huazhong University of Science and Technology, Wuhan, PR China

Correspondence Address:
Dr. Ming-Jun Cai
Department of Neurosurgery, Neurosurgical Institute of PLA, Department of Neurosurgery, Wuhan General Hospital, Guangzhou Military Command of PLA, 627 Wuluo Ave, Wuhan, Hubei 430070
PR China
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0028-3886.222873

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Aim: Limited clinical and angiographic data exists for patients with traumatic cervico-cerebral pseudoaneurysms. In this paper, we present our limited experience with various management strategies for traumatic cervico-cranial pseudoaneurysms. Materials and Methods: We retrospectively analyzed 37 consecutive cases of traumatic pseudoaneurysms involving the cervico-cranial or the cerebral arteries diagnosed at our center from September 2009 to December 2014. The demographic data, etiology, clinical presentation, lesion location, treatment modality, and follow-up outcomes of these patients were reviewed. Among these 37 patients, 5 patients were treated by surgery, while 29 patients were treated by the endovascular approach and 3 received conservative treatment. Results: During the study period, 42 pseudoaneurysms were identified in 37 patients with a history of head or neck injury. Five patients underwent surgical exploration of the lesion with an uneventful postoperative course. Twenty-nine patients were treated by endovascular interventions with various embolization materials including coils, stents, detachable balloons, liquid embolic agents, and a combination of these agents. The angiographic follow-up imaging demonstrated complete exclusion of the aneurysm from the circulation with the patient being free from any additional neurological deficits. Conclusion: Proper selection of an appropriate approach is essential to address the management of traumatic cervico-cerebral pseudoaneurysms. The treatment of traumatic cervico-cerebral pseudoaneurysms should be selected according to the location and the clinical features of the pseudoaneurysms. The endovascular treatment is a safe and effective modality and should be the first-line choice for treatment of traumatic pseudoaneurysms.






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