title: Endovascular treatment and radiographic follow-up of proximal traumatic intracranial aneurysms in adolescents: case series and review of the literature.
abstract: OBJECTIVE
  Traumatic intracranial aneurysms are rare lesions that are relatively more common in the pediatric population. Proximal traumatic aneurysms occur near the skull base. Direct surgical repair of these lesions is difficult due to the anatomically confined area, clinical status of a head injury patient, and the transmural nature of the injury. These lesions often lack a definable neck or wall suitable for clipping. While the indications and capabilities of endovascular treatment continue to expand, there are unanswered questions about the durability of treatment, especially in young patients. There are few reports examining the radiographic outcomes of endovascular treatment specifically for traumatic intracranial aneurysms. Therefore, we examined our experience treating these rare proximal lesions in an adolescent population.
  
  
  METHODS
  A retrospective review of prospectively collected data from 2000-2008 in a large, multidisciplinary neurovascular and trauma center was performed.
  
  
  RESULTS
  Three pediatric patients received endovascular treatment for traumatic intracranial aneurysms near the skull base. All patients had successful obliteration of their lesion without vessel sacrifice; however, two patients required multiple procedures for coil compaction or refilling of the aneurysm. There were no complications or ischemic events related to treatment. Follow-up imaging ranged from 6 months to 3.5 years.
  
  
  CONCLUSIONS
  Traumatic intracranial aneurysms at the skull base can be successfully treated with endovascular methods; however, close follow-up is necessary.
authors.affiliation: Division of Pediatric Neurosurgery, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA. d_fulkers@hotmail.com
authors.forename: Daniel H
authors.initials: DH
authors.lastname: Fulkerson
authors.forename: Jason M
authors.initials: JM
authors.lastname: Voorhies
authors.forename: Shannon P
authors.initials: SP
authors.lastname: McCanna
authors.forename: Troy D
authors.initials: TD
authors.lastname: Payner
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Leipzig
authors.forename: John A
authors.initials: JA
authors.lastname: Scott
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: DeNardo
authors.forename: Kathleen
authors.initials: K
authors.lastname: Redelman
authors.forename: Terry G
authors.initials: TG
authors.lastname: Horner
mesh_terms: D000293:Adolescent; D001930:Brain Injuries / Q000150:complications / Q000473:pathology / Q000601:surgery; D002533:Cerebral Angiography; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000209:etiology / Q000601:surgery*; D008297:Male; D019635:Neurosurgical Procedures / Q000379:methods*; D019736:Prostheses and Implants; D019291:Skull Base / Q000293:injuries / Q000601:surgery; D015607:Stents; D014656:Vascular Surgical Procedures / Q000379:methods*