Endovascular therapy of traumatic injuries of the intracranial cerebral arteries

Dissections, pseudoaneurysms, and fistulas may result from traumatic injuries to the intracranial arteries in the setting of closed head injury, penetrating skull trauma, or angiography. Endovascular therapy with particle or coil embolization, balloon occlusion, or stent deployment are potential treatments for this heterogeneous group of lesions. These arterial injuries usually manifest in a delayed fashion with intracranial hemorrhage, cerebral ischemia, or epistaxis. Principles of neurologic critical care that minimize secondary brain injury are essential adjuncts in patient management. This article emphasizes a coordinated approach to the endovascular treatment and neurologic critical care of these patients.