Traumatic vascular injuries and their management.
Traumatic vascular injury to the intracranial and extracranial circulation can be sequelae of blunt, penetrating, or iatrogenic insults to the head, face, or neck. Treatment options include conservative medical management, or more invasive surgical or endovascular therapy. The appropriate treatment depends on the risk-benefit ratio of each option considering the natural history of each. Injuries include mild intimal irregularities, intimal flaps, pseudoaneurysms, fistulas, and occlusions. Need for treatment is partly determined by the collateral circulation to the brain, and the degree to which the lesion is thrombogenic. Advances in endovascular devices and techniques provide us with less invasive alternatives to surgery intervention or allow the interventionalist to treat lesions not treatable by any other modality.
Larsen
Donald W
DW
Department of Neurological Surgery and Radiology, Keck School of Medicine, University of Southern California, Department of Interventional Neuroradiology, University of Southern California Medical Center, Los Angeles, CA, USA. dwlarsen@neurosolutions.org
D000792:Angiography; D020212:Carotid Artery Injuries / Q000175:diagnosis* / Q000628:therapy; D002533:Cerebral Angiography; D002536:Cerebral Arteries / Q000293:injuries*; D005145:Face / Q000098:blood supply; D005151:Facial Injuries / Q000175:diagnosis / Q000628:therapy; D006801:Humans; D018810:Magnetic Resonance Angiography; D019838:Neck Injuries / Q000175:diagnosis; D018616:Ultrasonography, Doppler, Duplex; D016157:Vascular Fistula / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D014711:Vertebral Artery / Q000293:injuries*