Multidisciplinary approach to traumatic intracranial aneurysms secondary to shotgun and handgun wounds

BACKGROUND Traumatic intracranial aneurysms (TICAs) may develop following g unshot injuries to the head. Management of these lesions often combines var ious aspects of micro-neurosurgical and endovascular techniques to safely r epair or obliterate vessel defects. METHODS We reviewed our experience over the last 18 years and identified fi ve cases of intracranial aneurysms following gunshot and handgun wounds tha t were treated surgically and/or endovascularly. RESULTS All patients had successful obliteration of their lesions using a v ariety of therapeutic modalities aimed at preserving neurologic function wh ile at the same time eliminating the aneurysm from the circulation. CONCLUSION Both micro-neurosurgery and endovascular surgery have important roles to play in the management of TICAs. In some cases, both methods can b e combined to eliminate lesions and maximize patient recovery in a safe, ef ficient, and effective fashion. (C) 1999 by Elsevier Science Inc.