Systematic review of traumatic intracranial aneurysms: Insights into diagnosis, treatment, and prognosis

Abstract

Objective

To provide a comprehensive overview of the incidence, diagnosis, treatment, and outcomes of traumatic intracranial aneurysms (TICAs).

Methods

A systematic review was conducted following the PRISMA guidelines. Five studies published between 2000 and 2015 were included, encompassing a total of 732 patients. Data on patient demographics, mechanisms of injury, diagnostic timing and modalities, aneurysm characteristics, treatment approaches, and outcomes were extracted and analyzed.

Results

Out of 732 patients, 92 were diagnosed with TICAs. The incidence of TICAs varied across studies, with a higher prevalence in males. The mean age of patients ranged from 10.74 to 47.3 years. Closed head injuries were the predominant cause of TICAs, except in one study where penetrating injuries were more common. Diagnostic imaging, primarily using digital subtraction angiography (DSA) and computed tomography angiography (CTA), were critical for accurate detection. The most common aneurysm locations were the anterior cerebral artery (ACA) and middle cerebral artery (MCA), with mean sizes ranging from 4.08 mm to 4.72 mm. Treatment modalities included surgical and endovascular interventions, with endovascular treatment showing favorable neurological outcomes and better parent artery preservation in most reported cases. Mortality rates varied, with the lowest reported at 0.08.

Conclusion

TICAs are a rare but serious complication of head trauma that require prompt diagnosis and treatment. Advanced imaging techniques and early intervention, particularly through endovascular methods, significantly improve patient outcomes. Further research is needed to establish standardized diagnostic and therapeutic protocols for the optimal management of TICAs.