Skip to main content

Advertisement

SpringerLink
Log in

Endoluminal flow diversion as a primary treatment strategy for pediatric traumatic intracranial aneurysms: a case-based review of literature

  • Review
  • Published:
Child's Nervous System Aims and scope Submit manuscript

Abstract

Background

Traumatic intracranial aneurysms (TICAs) constitute a notable portion of pediatric intracranial aneurysms. Their unstable structure dictates a high incidence of rupture or mass effect from enlarging unruptured aneurysms, necessitating prompt diagnosis and treatment. TICAs often lack a true neck or are wide-necked, making them unsuitable for coil embolization and surgical clipping, and their fragile nature poses a risk of rupture during surgical and intrasaccular interventions. Endoluminal flow diverters (FD), deployed without requiring direct access to the aneurysmal sac, have emerged as an appealing sole treatment modality for TICAs. However, the clinical experience with this technique remains limited in the pediatric population.

Method

We describe the successful treatment of a paraclinoid TICA in a 4-year-old female using an endoluminal FD alone. Additionally, we conducted a literature review to assess the safety and effectiveness of this treatment modality in pediatric TICAs.

Results

Endoluminal flow diversion led to complete aneurysm obliteration in our case, with no observed complication, at the 9-month follow-up. Our review of the previously reported pediatric TICAs managed by standalone flow diversion highlights this technique as safe, efficient, and promising as a sole treatment modality, particularly in the anterior circulation, with a high rate of persistent total obliteration and a low rate of complications. However, the requirement for long-term antiplatelet therapy with the possibility of frequent dose monitoring and adjustments warrants special attention when using endoluminal FDs. Until guidelines specifically addressing optimal antiplatelet therapy in children with intracranial FDs are formulated, adherence to existing protocols is imperative to avoid in-stent thrombosis.

Conclusion

Our literature review and personal experience indicate that endoluminal flow diversion can be a viable treatment approach for pediatric TICAs. However, prospective studies with extensive follow-ups are required to assess the durability of endoluminal FDs in treating pediatric TICAs, considering the long life expectancy of this demographic.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

Data availability

All data supporting the findings of this study are available within the paper, with appropriate citations to their original sources.

References

  1. Huang J, McGirt MJ, Gailloud P, Tamargo RJ (2005) Intracranial aneurysms in the pediatric population: case series and literature review. Surg Neurol 63:424–432; discussion 432–423. https://doi.org/10.1016/j.surneu.2004.11.023

  2. Gemmete JJ, Toma AK, Davagnanam I, Robertson F, Brew S (2013) Pediatric cerebral aneurysms. Neuroimaging Clin N Am 23:771–779. https://doi.org/10.1016/j.nic.2013.03.018

    Article  PubMed  Google Scholar 

  3. Meyer FB, Sundt TM Jr, Fode NC, Morgan MK, Forbes GS, Mellinger JF (1989) Cerebral aneurysms in childhood and adolescence. J Neurosurg 70:420–425. https://doi.org/10.3171/jns.1989.70.3.0420

    Article  CAS  PubMed  Google Scholar 

  4. Larson PS, Reisner A, Morassutti DJ, Abdulhadi B, Harpring JE (2000) Traumatic intracranial aneurysms. Neurosurg Focus 8:1–6. https://doi.org/10.3171/foc.2000.8.1.1829

    Article  Google Scholar 

  5. Holmes B, Harbaugh RE (1993) Traumatic intracranial aneurysms: a contemporary review. J Trauma 35:855–860

    Article  CAS  PubMed  Google Scholar 

  6. Parkinson D, West M (1980) Traumatic intracranial aneurysms. J Neurosurg 52:11–20. https://doi.org/10.3171/jns.1980.52.1.0011

    Article  CAS  PubMed  Google Scholar 

  7. Hejrati N, Ebel F, Guzman R, Soleman J (2020) Posttraumatic cerebrovascular injuries in children. A systematic review Childs Nerv Syst 36:251–262. https://doi.org/10.1007/s00381-019-04482-9

    Article  PubMed  Google Scholar 

  8. Zheng Y, Lu Z, Shen J, Xu F (2020) Intracranial Pseudoaneurysms: evaluation and management. Front Neurol 11:582. https://doi.org/10.3389/fneur.2020.00582

    Article  PubMed  PubMed Central  Google Scholar 

  9. Liang JT, Huo LR, Bao YH, Zhang HQ, Wang ZY, Ling F (2011) Intracranial aneurysms in adolescents. Childs Nerv Syst 27:1101–1107. https://doi.org/10.1007/s00381-010-1334-4

    Article  PubMed  Google Scholar 

  10. Ventureyra EC, Higgins MJ (1994) Traumatic intracranial aneurysms in childhood and adolescence. Case reports and review of the literature. Childs Nerv Syst 10:361–379. https://doi.org/10.1007/bf00335125

    Article  CAS  PubMed  Google Scholar 

  11. Nakstad P, Nornes H, Hauge HN (1986) Traumatic aneurysms of the pericallosal arteries. Neuroradiology 28:335–338. https://doi.org/10.1007/bf00333440

    Article  CAS  PubMed  Google Scholar 

  12. Yazbak PA, McComb JG, Raffel C (1995) Pediatric traumatic intracranial aneurysms. Pediatr Neurosurg 22:15–19. https://doi.org/10.1159/000121294

    Article  CAS  PubMed  Google Scholar 

  13. Livshits IM, Berdinov BF, Musa G, Chmutin EG, Levov VA, Chmutin GK, Zokhidov UZ (2022) Traumatic intracranial aneurysms (TICA) in children: a description of two clinical cases of successful treatment and review of literature. Childs Nerv Syst 38:2063–2070. https://doi.org/10.1007/s00381-022-05647-9

    Article  PubMed  Google Scholar 

  14. Adepoju A, Adamo MA (2017) Posttraumatic complications in pediatric skull fracture: dural sinus thrombosis, arterial dissection, and cerebrospinal fluid leakage. J Neurosurg Pediatr 20:598–603. https://doi.org/10.3171/2017.6.Peds16702

    Article  PubMed  Google Scholar 

  15. Sastry RA, Koch MJ, Grannan BL, Stapleton CJ, Butler WE, Patel AB (2018) Flow diversion of a recurrent, iatrogenic basilar tip aneurysm in a pediatric patient: case report. Journal of Neurosurgery: Pediatrics PED 21:90–93. https://doi.org/10.3171/2017.7.Peds17235

    Article  Google Scholar 

  16. Sami MT, Gattozzi DA, Soliman HM, Reeves AR, Moran CJ, Camarata PJ, Ebersole KC (2018) Use of Pipeline™ embolization device for the treatment of traumatic intracranial pseudoaneurysms: case series and review of cases from literature. Clin Neurol Neurosurg 169:154–160. https://doi.org/10.1016/j.clineuro.2018.04.012

    Article  PubMed  Google Scholar 

  17. Budohoski KP, Thakrar R, Voronovich Z, Rennert RC, Kilburg C, Grandhi R, Couldwell WT, Brockmeyer DL, Taussky P (2022) Initial experience with Pipeline embolization of intracranial pseudoaneurysms in pediatric patients. J Neurosurg Pediatr 30:465–473. https://doi.org/10.3171/2022.7.PEDS22195

    Article  Google Scholar 

  18. Cherian J, Srinivasan V, Froehler MT, Grossberg JA, Cawley CM, Hanel RA, Puri A, Dumont T, Ducruet AF, Albuquerque F (2020) Flow diversion for treatment of intracranial aneurysms in pediatric patients: multicenter case series. Neurosurgery 87:53–62. https://doi.org/10.1093/neuros/nyz380

    Article  PubMed  Google Scholar 

  19. Pierot L (2011) Flow diverter stents in the treatment of intracranial aneurysms: where are we? J Neuroradiol 38:40–46. https://doi.org/10.1016/j.neurad.2010.12.002

    Article  PubMed  Google Scholar 

  20. D’Urso PI, Lanzino G, Cloft HJ, Kallmes DF (2011) Flow diversion for intracranial aneurysms: a review. Stroke 42:2363–2368. https://doi.org/10.1161/strokeaha.111.620328

    Article  PubMed  Google Scholar 

  21. Wong GK, Kwan MC, Ng RY, Yu SC, Poon WS (2011) Flow diverters for treatment of intracranial aneurysms: current status and ongoing clinical trials. J Clin Neurosci 18:737–740. https://doi.org/10.1016/j.jocn.2010.10.011

    Article  PubMed  Google Scholar 

  22. Federal Drug Administration Pipeline™ Embolization Device premarket approval. March 20, 2011. https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpma/pma.cfm?id=P100018. Accessed 28 July 2023

  23. Vargas SA, Diaz C, Herrera DA, Dublin AB (2016) Intracranial aneurysms in children: the role of stenting and flow-diversion. J Neuroimaging 26:41–45. https://doi.org/10.1111/jon.12305

    Article  PubMed  Google Scholar 

  24. Lin N, Lanzino G, Lopes DK, Arthur AS, Ogilvy CS, Ecker RD, Dumont TM, Turner RDt, Gooch MR, Boulos AS, Kan P, Snyder KV, Levy EI, Siddiqui AH, (2016) Treatment of distal anterior circulation aneurysms with the pipeline embolization device: a US multicenter experience. Neurosurgery 79:14–22. https://doi.org/10.1227/neu.0000000000001117

    Article  PubMed  Google Scholar 

  25. Cobb MIH, Zomorodi AR, Hauck EF, Smith TP, Fernando Gonzalez L (2017) Optimal pediatric dosing of anti-platelet agents for pipeline stent embolization -a case report and review of the literature. Childs Nerv Syst 33:685–690. https://doi.org/10.1007/s00381-016-3311-z

    Article  PubMed  Google Scholar 

  26. Barburoglu M, Arat A (2017) Flow diverters in the treatment of pediatric cerebrovascular diseases. AJNR Am J Neuroradiol 38:113–118. https://doi.org/10.3174/ajnr.A4959

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  27. Ghali MG, Srinivasan VM, Cherian J, Wagner KM, Chen SR, Johnson J, Lam SK, Kan P (2018) Multimodal treatment of intracranial aneurysms in children: clinical case series and review of the literature. World neurosurgery 111:e294–e307. https://doi.org/10.1016/j.wneu.2017.12.057

    Article  PubMed  Google Scholar 

  28. Topcuoglu OM, Akgul E, Daglioglu E, Topcuoglu ED, Peker A, Akmangit I, Belen D, Arat A (2016) Flow diversion in middle cerebral artery aneurysms: is it really an all-purpose treatment? World neurosurgery 87:317–327. https://doi.org/10.1016/j.wneu.2015.11.073

    Article  PubMed  Google Scholar 

  29. Özkan Arat Y, Arat A, Aydın K (2015) Cerebrovascular complications of transorbital penetrating intracranial injuries. Ulus Travma Acil Cerrahi Derg 21:271–278. https://doi.org/10.5505/tjtes.2015.48839

    Article  PubMed  Google Scholar 

  30. Santos-Franco JA, Cruz-Argüelles CA, Agustin-Aguilar F, Abrego-Salinas AA, Casas-Martínez MR, Olivares-Peña JL (2022) Intracranial aneurysms in pediatric population treated with flow diverters: a single-center experience. Surg Neurol Int 13. https://doi.org/10.25259/SNI_873_2022

  31. Cooper A (1836) Account of the first successful operation performed on the common carotid artery for aneurysm in the year 1808 with the postmortem examination in the year 1821. Guys Hosp Rep 1:53–59

    Google Scholar 

  32. Sayin B, Dereli B, Senol YC, Akmangit I, Karaman A, Daglioglu E, Belen AD (2023) The evaluation of Low-Profile Surpass Evolve(TM) flow diverter for endovascular treatment of distal cerebral artery aneurysms: a single-center experience. Turk Neurosurg 33:477–487. https://doi.org/10.5137/1019-5149.Jtn.42071-22.1

    Article  PubMed  Google Scholar 

  33. Doron O, McLellan R, Vranic JE, Regenhardt RW, Stapleton CJ, Patel AB (2023) FRED Jr stent for acute flow diversion in ruptured cerebral aneurysms arising from small-caliber vessels: a clinical case series. Neurosurg Focus 54:E6. https://doi.org/10.3171/2023.2.Focus22645

    Article  PubMed  Google Scholar 

  34. Turjman F, Acevedo G, Moll T, Duquesnel J, Eloy R, Sindou M (1993) Treatment of experimental carotid aneurysms by endoprosthesis implantation: preliminary report. Neurol Res 15:181–184. https://doi.org/10.1080/01616412.1993.11740132

    Article  CAS  PubMed  Google Scholar 

  35. Yang TC, Lo YL, Huang YC, Yang ST (2007) Traumatic anterior cerebral artery aneurysm following blunt craniofacial trauma. Eur Neurol 58:239–245. https://doi.org/10.1159/000107970

    Article  PubMed  Google Scholar 

  36. Kim M, Lee HS, Lee S, Park JC, Ahn JS, Kwon DH, Kwun BD, Park W (2019) Pediatric intracranial aneurysms: favorable outcomes despite rareness and complexity. World Neurosurg 125:e1203–e1216. https://doi.org/10.1016/j.wneu.2019.01.280

    Article  PubMed  Google Scholar 

  37. Das AS, Vicenty-Padilla JC, Chua MM, Jeelani Y, Snider SB, Regenhardt RW, Al-Mufti F, Du R, Izzy S (2022) Cerebrovascular injuries in traumatic brain injury. Clin Neurol Neurosurg 107479. https://doi.org/10.1016/j.clineuro.2022.107479

  38. deSouza RM, Shah M, Koumellis P, Foroughi M (2016) Subarachnoid haemorrhage secondary to traumatic intracranial aneurysm of the posterior cerebral circulation: case series and literature review. Acta Neurochir (Wien) 158:1731–1740. https://doi.org/10.1007/s00701-016-2865-6

    Article  PubMed  Google Scholar 

  39. Bell RS, Vo AH, Roberts R, Wanebo J, Armonda RA (2010) Wartime traumatic aneurysms: acute presentation, diagnosis, and multimodal treatment of 64 craniocervical arterial injuries. Neurosurgery 66:66–79; discussion 79. https://doi.org/10.1227/01.Neu.0000361285.50218.A8

  40. Aarabi B (1995) Management of traumatic aneurysms caused by high-velocity missile head wounds. Neurosurg Clin N Am 6:775–797. https://doi.org/10.1016/S1042-3680(18)30432-7

    Article  CAS  PubMed  Google Scholar 

  41. Miller PR, Fabian TC, Croce MA, Cagiannos C, Williams JS, Vang M, Qaisi WG, Felker RE, Timmons SD (2002) Prospective screening for blunt cerebrovascular injuries: analysis of diagnostic modalities and outcomes. Ann Surg 236:386. https://doi.org/10.1097/01.sla.0000027174.01008.a0

    Article  PubMed  PubMed Central  Google Scholar 

  42. Chen X, Liu Y, Tong H, Dong Y, Ma D, Xu L, Yang C (2018) Meta-analysis of computed tomography angiography versus magnetic resonance angiography for intracranial aneurysm. Medicine 97:e10771. https://doi.org/10.1097/md.0000000000010771

  43. Lauzier DC, Huguenard AL, Srienc AI, Cler SJ, Osbun JW, Chatterjee AR, Vellimana AK, Kansagra AP, Derdeyn CP, Cross DT, Moran CJ (2023) A review of technological innovations leading to modern endovascular brain aneurysm treatment. Front Neurol 14. https://doi.org/10.3389/fneur.2023.1156887

  44. Lee Y-J, Kim DJ, Suh SH, Lee S-K, Kim J, Kim DI (2005) Stent-assisted coil embolization of intracranial wide-necked aneurysms. Neuroradiology 47:680–689. https://doi.org/10.1007/s00234-005-1402-8

    Article  PubMed  Google Scholar 

  45. Pruvot AS, Curey S, Derrey S, Castel H, Proust F (2016) Giant intracranial aneurysms in the paediatric population: suggested management and a review of the literature. Neurochirurgie 62:20–24. https://doi.org/10.1016/j.neuchi.2013.06.004

    Article  PubMed  Google Scholar 

  46. Lasjaunias PL, Campi A, Rodesch G, Alvarez H, Kanaan I, Taylor W (1997) Aneurysmal disease in children. Review of 20 cases with intracranial arterial localisations. Interv Neuroradiol 3:215–229. https://doi.org/10.1177/159101999700300304

    Article  CAS  PubMed  Google Scholar 

  47. Chen R, Zhang S, Guo R, You C, Ma L (2018) Pediatric intracranial pseudoaneurysms: a report of 15 cases and review of the literature. World Neurosurg 116:e951–e959. https://doi.org/10.1016/j.wneu.2018.05.140

    Article  PubMed  Google Scholar 

  48. Gerosa A, Fanti A, Del Sette B, Bianco A, Cossandi C, Crobeddu E, Forgnone S, Fornaro R, Panzarasa G (2019) Posttraumatic middle meningeal artery pseudoaneurysm: case report and review of the literature. World Neurosurg 128:225–229. https://doi.org/10.1016/j.wneu.2019.05.030

    Article  PubMed  Google Scholar 

  49. Fry L, Brake A, Heskett C, LeBeau G, De Stefano FA, Alkiswani AR, Lei C, Le K, Peterson J, Ebersole K (2023) Endovascular management of pediatric traumatic intracranial pseudoaneurysms: a systematic review and case series. World Neurosurg. https://doi.org/10.1016/j.wneu.2023.04.028

    Article  PubMed  Google Scholar 

  50. Trivelato FP, Rezende MTS, Fonseca LV, Bonadio LE, Ulhôa AC, Abud DG (2017) Pipeline embolization device for the treatment of a traumatic intracranial aneurysm in a child. Childs Nerv Syst 33:869–872. https://doi.org/10.1007/s00381-016-3334-5

    Article  PubMed  Google Scholar 

  51. Sadasivan C, Cesar L, Seong J, Rakian A, Hao Q, Tio FO, Wakhloo AK, Lieber BB (2009) An original flow diversion device for the treatment of intracranial aneurysms: evaluation in the rabbit elastase-induced model. Stroke 40:952–958. https://doi.org/10.1161/strokeaha.108.533760

    Article  PubMed  PubMed Central  Google Scholar 

  52. Hemphill JC 3rd, Gress DR, Halbach VV (1999) Endovascular therapy of traumatic injuries of the intracranial cerebral arteries. Crit Care Clin 15:811–829. https://doi.org/10.1016/s0749-0704(05)70089-0

    Article  PubMed  Google Scholar 

  53. Patel PD, Chalouhi N, Atallah E, Tjoumakaris S, Hasan D, Zarzour H, Rosenwasser R, Jabbour P (2017) Off-label uses of the Pipeline embolization device: a review of the literature. Neurosurg Focus 42:E4. https://doi.org/10.3171/2017.3.FOCUS1742

    Article  PubMed  Google Scholar 

  54. Greving JP, Wermer MJ, Brown RD Jr, Morita A, Juvela S, Yonekura M, Ishibashi T, Torner JC, Nakayama T, Rinkel GJ, Algra A (2014) Development of the PHASES score for prediction of risk of rupture of intracranial aneurysms: a pooled analysis of six prospective cohort studies. Lancet Neurol 13:59–66. https://doi.org/10.1016/s1474-4422(13)70263-1

    Article  PubMed  Google Scholar 

  55. Toth G, Bain M, Hussain MS, Moskowitz S, Masaryk T, Rasmussen P, Hui F (2015) Posterior circulation flow diversion: a single-center experience and literature review. J Neurointerv Surg 7:574–583. https://doi.org/10.1136/neurintsurg-2014-011281

    Article  PubMed  Google Scholar 

  56. Siddiqui AH, Abla AA, Kan P, Dumont TM, Jahshan S, Britz GW, Hopkins LN, Levy EI (2012) Panacea or problem: flow diverters in the treatment of symptomatic large or giant fusiform vertebrobasilar aneurysms. J Neurosurg 116:1258–1266. https://doi.org/10.3171/2012.2.Jns111942

    Article  PubMed  Google Scholar 

  57. Cruz J, Chow M, O’Kelly C, Marotta B, Spears J, Montanera W, Fiorella D, Marotta T (2012) Delayed ipsilateral parenchymal hemorrhage following flow diversion for the treatment of anterior circulation aneurysms. Am J Neuroradiol 33:603–608. https://doi.org/10.3174/ajnr.A3065

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  58. Cruz JP, O’Kelly C, Kelly M, Wong JH, Alshaya W, Martin A, Spears J, Marotta TR (2013) Pipeline embolization device in aneurysmal subarachnoid hemorrhage. AJNR Am J Neuroradiol 34:271–276. https://doi.org/10.3174/ajnr.A3380

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  59. Arat YO, Arat A, Aydin K (2015) Angiographic morphometry of internal carotid artery circulation in Turkish children. Turk Neurosurg 25:608–616. https://doi.org/10.5137/1019-5149.Jtn.13788-14.1

    Article  PubMed  Google Scholar 

  60. Scoville J, Joyce E, Baker C, Dewey J, Grandhi R, Taussky P (2021) Analyzing the safety and efficacy of flow-diverting stents in pediatric aneurysms: a systematic review. Neurosurgery 89:154–163. https://doi.org/10.1093/neuros/nyab120

    Article  PubMed  Google Scholar 

  61. Bounajem MT, Joyce E, Scoville JP, Seinfeld J, Hoffman J, Grossberg JA, Waiters V, White AC, Nerva J, Burkhardt JK, Tonetti DA, El Naamani K, Gooch MR, Jabbour P, Tjoumakaris S, Ortega Gutierrez S, Levitt MR, Lang M, Ares WJ, Desai S, Mascitelli JR, Kilburg CJ, Budohoski KP, Couldwell WT, Gross BA, Grandhi R (2023) Safety and efficacy of the pipeline flex embolization device with Shield Technology for the acute treatment of ruptured internal carotid artery pseudoaneurysms: a multi-institution case series. Neurosurg Focus 54:E4. https://doi.org/10.3171/2023.2.Focus233

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Neurosurgery, Shiraz University of Medical Sciences, Shiraz, Iran

    Ehsan Mohammad Hosseini & Reza Rafieossadat

  2. Department of Surgery, Rafsanjan University of Medical Sciences, Rafsanjan, Kerman, Iran

    Saber Zafarshamspour

  3. Department of Interventional Radiology, Baylor College of Medicine, Houston, TX, USA

    Mohammad Ghasemi-Rad

  4. Department of Radiology, University Hospital Rigshospitalet, Copenhagen, Denmark

    Goetz Benndorf

  5. Department of Radiology, Baylor College of Medicine, Houston, TX, USA

    Goetz Benndorf

  6. Department of Radiology, Shiraz University of Medical Sciences, Shiraz, Iran

    Alireza Rasekhi

Authors
  1. Ehsan Mohammad Hosseini
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Saber Zafarshamspour
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mohammad Ghasemi-Rad
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Goetz Benndorf
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Alireza Rasekhi
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Reza Rafieossadat
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

All authors contributed to the study conception and design. The literature search and collection of relevant articles were performed by Reza Rafieossadat. Critical analysis and interpretation of the articles were performed by Ehsan Mohammad Hosseini and Saber Zafarshamspour. The first draft of the manuscript was written by Reza Rafieossadat. All authors commented on previous versions of the manuscript and critically revised the work. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Reza Rafieossadat.

Ethics declarations

Ethics approval

This study was conducted in accordance with ethical standards and was approved by the Institutional Research Ethics Committee of Shiraz University of Medical Sciences.

Conflict of interest

The authors declare no conflict of interests.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Hosseini, E.M., Zafarshamspour, S., Ghasemi-Rad, M. et al. Endoluminal flow diversion as a primary treatment strategy for pediatric traumatic intracranial aneurysms: a case-based review of literature. Childs Nerv Syst 40, 345–357 (2024). https://doi.org/10.1007/s00381-023-06161-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00381-023-06161-2

Keywords

Search

Navigation