NYMC Faculty Publications

Neuroendovascular Surgery Applications in Craniocervical Trauma

Michael Kim, Department of Neurosurgery, Westchester Medical Center at New York Medical College, Valhalla, NY 10595, USA.
Galadu Subah, Department of Neurosurgery, Westchester Medical Center at New York Medical College, Valhalla, NY 10595, USA.
Jared Cooper, Department of Neurosurgery, Westchester Medical Center at New York Medical College, Valhalla, NY 10595, USA.
Michael Fortunato, Department of Neurology, Westchester Medical Center at New York Medical College, Valhalla, NY 10595, USA.
Bridget Nolan, Department of Neurosurgery, Westchester Medical Center at New York Medical College, Valhalla, NY 10595, USA.
Christian Bowers, Department of Neurosurgery, University of New Mexico, Albuquerque, NM 87108, USA.
Kartik Prabhakaran, Department of Surgery, Division of Trauma and Acute Care Surgery, Westchester Medical Center at New York Medical College, Valhalla, NY 10595, USA.
Rolla Nuoman, Department of Neurology, Maria Fareri Children's Hospital, Westchester Medical Center at New York Medical College, Valhalla, NY 10595, USA.
Krishna Amuluru, Goodman Campbell Brain and Spine, Indianapolis, IN 46032, USA.Follow
Sauson Soldozy, Department of Neurosurgery, Westchester Medical Center at New York Medical College, Valhalla, NY 10595, USA.
Alvin S. Das, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA.
Robert W. Regenhardt, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02215, USA.
Saef Izzy, Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02215, USA.
Chirag Gandhi, Department of Neurosurgery, Westchester Medical Center at New York Medical College, Valhalla, NY 10595, USA.
Fawaz Al-Mufti, Department of Neurology, Westchester Medical Center at New York Medical College, Valhalla, NY 10595, USA.Follow

Author Type(s)

Faculty

DOI

10.3390/biomedicines11092409

Journal Title

Biomedicines

Document Type

Article

Publication Date

8-28-2023

Department

Neurosurgery

Second Department

Surgery

Third Department

Pediatrics

Abstract

Cerebrovascular injuries resulting from blunt or penetrating trauma to the head and neck often lead to local hemorrhage and stroke. These injuries present with a wide range of manifestations, including carotid or vertebral artery dissection, pseudoaneurysm, occlusion, transection, arteriovenous fistula, carotid-cavernous fistula, epistaxis, venous sinus thrombosis, and subdural hematoma. A selective review of the literature from 1989 to 2023 was conducted to explore various neuroendovascular surgical techniques for craniocervical trauma. A PubMed search was performed using these terms: endovascular, trauma, dissection, blunt cerebrovascular injury, pseudoaneurysm, occlusion, transection, vasospasm, carotid-cavernous fistula, arteriovenous fistula, epistaxis, cerebral venous sinus thrombosis, subdural hematoma, and middle meningeal artery embolization. An increasing array of neuroendovascular procedures are currently available to treat these traumatic injuries. Coils, liquid embolics (onyx or n-butyl cyanoacrylate), and polyvinyl alcohol particles can be used to embolize lesions, while stents, mechanical thrombectomy employing stent-retrievers or aspiration catheters, and balloon occlusion tests and super selective angiography offer additional treatment options based on the specific case. Neuroendovascular techniques prove valuable when surgical options are limited, although comparative data with surgical techniques in trauma cases is limited. Further research is needed to assess the efficacy and outcomes associated with these interventions.

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