Extracranial traumatic aneurysms due to blunt cerebrovascular injury

Object Traumatic aneurysms occur in 10% of extracranial blunt traumatic cerebrovascular injuries (TCVI). The clinical consequences and optimal management of traumatic aneurysms are poorly understood. Methods A prospective study of TCVI at a Level I trauma center identified 7 patients with 19 extracranial traumatic carotid artery or vertebral artery aneurysms. An additional 6 patients with 7 traumatic aneurysms were followed outside of the prospective study, giving a total of 13 patients with 26 traumatic aneurysms. All patients were treated with 325 mg aspirin daily and underwent clinical and imaging follow-up beyond the initial hospitalization. Endovascular treatment was reserved for aneurysms demonstrating significant enlargement on follow-up imaging. Clinical and radiographic features were assessed. Results The 7 patients with traumatic aneurysms identified in the prospective cohort comprised 10.3% of all patients with TCVI. Two (15.4%) of the 13 total patients suffered an ischemic stroke in the settin...