{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T15:42:12Z","timestamp":1782402132554,"version":"3.54.5"},"reference-count":56,"publisher":"SAGE Publications","issue":"15-16","license":[{"start":{"date-parts":[[2024,8,1]],"date-time":"2024-08-01T00:00:00Z","timestamp":1722470400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Neurotrauma"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:p>In previous studies, the incidence of traumatic intracranial aneurysms (TICAs) after civilian gunshot wound to the head (cGSWH) was \u223c3%. Given the use of delayed vessel imaging, we hypothesize that a significant fraction of TICAs is missed on initial non-contrasted scans. This study was designed to characterize acute TICAs using admission computed tomographic angiography (aCTA) in cGSWH. Over the period from 2017 to 2022, 341 patients were admitted to R. Adams Cowley Shock Trauma Center with cGSWH; 136 subjects had aCTA \u223c3 (standard deviation [SD] 3.5) h post-injury. Demographics, clinical findings, imaging techniques, endovascular\/surgical interventions, and outcomes were analyzed. Mean age was 34.7 (SD 13.1), male:female ratio was 120:16. Average admission Glasgow Coma Scale (GCS) score was 6 (SD 3.9). Entry site was frontal in 41, temporal in 55, parietal in 18, occipital in 6, suboccipital in 9, temporo-parietal in 1, and frontobasal-temporal in 6. Projectiles crossed multiple dural compartments in 76 (55%) patients. 35 TICAs were diagnosed in 28 subject: 24 were located along the middle cerebral artery (MCA), 6 in the anterior cerebral artery (ACA), 3 in the internal carotid artery (ICA), 1 in the posterior cerebral artery (PCA), and 1 in the middle meningeal artery (MMA). Eleven TICAs resolved spontaneously in nine patients. Eight aneurysms were treated by endovascular means, two via combined endovascular\/open approaches. Forty-nine patients died, 10 of whom had 15 TICAs. Eighty patients developed intracerebral hematoma s (ICHs). Regression models showed that the presence of an ICH was the main predictor of TICA in cGSWH. Larger ICHs (average 22.3 cc vs. 9.4 cc in patients with and without aneurysms, respectively) in patients with cGSWH suggest hidden TICAs. Nearly 30% of patients had spontaneous resolution within 1 week. When CTA was performed acutely, TICAs were 10 times more frequent in cGSWH than in previous literature, and those patients were more likely to proceed to surgery. Almost one third of patients in this series died from the devastating effects of cGSWH.<\/jats:p>","DOI":"10.1089\/neu.2023.0576","type":"journal-article","created":{"date-parts":[[2024,2,3]],"date-time":"2024-02-03T03:03:25Z","timestamp":1706929405000},"page":"1871-1882","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Acute Development of Traumatic Intracranial Aneurysms After Civilian Gunshot Wounds to the Head"],"prefix":"10.1177","volume":"41","author":[{"given":"Riccardo","family":"Serra","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, University of Maryland, Baltimore, Maryland, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bradley","family":"Wilhelmy","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Maryland, Baltimore, Maryland, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chixiang","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Maryland, Baltimore, Maryland, USA."},{"name":"Department of Epidemiology and Public Health, Division of Biostatistics and Bioinformatics, R. Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, Maryland, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey D.","family":"Oliver","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Maryland, Baltimore, Maryland, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jesse A.","family":"Stokum","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Maryland, Baltimore, Maryland, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uttam K.","family":"Bodanapally","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Radiology and Nuclear Medicine, R. Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, Maryland, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. Marc","family":"Simard","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Maryland, Baltimore, Maryland, USA."},{"name":"Department of Physiology, University of Maryland, Baltimore, Maryland, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gary","family":"Schwartzbauer","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Maryland, Baltimore, Maryland, USA."},{"name":"Program in Trauma, R. Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, Maryland, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bizhan","family":"Aarabi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Maryland, Baltimore, Maryland, USA."},{"name":"Program in Trauma, R. Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, Maryland, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,8,20]]},"reference":[{"key":"e_1_3_7_2_2","doi-asserted-by":"publisher","DOI":"10.1227\/00006123-198011000-00016"},{"key":"e_1_3_7_3_2","doi-asserted-by":"publisher","DOI":"10.1227\/00006123-198806010-00014"},{"key":"e_1_3_7_4_2","doi-asserted-by":"publisher","DOI":"10.1227\/00006123-199101000-00001"},{"key":"e_1_3_7_5_2","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1996.84.5.0769"},{"key":"e_1_3_7_6_2","first-page":"302","article-title":"Ein s\u00e4ckchenf\u00f6rmiges Aneurysma der A","volume":"15","author":"Finkemeyer H.","year":"1955","unstructured":"Finkemeyer H. Ein s\u00e4ckchenf\u00f6rmiges Aneurysma der A. cerebri media als postoperative Komplikation. [Patients are considered neurologically non-recoverable in clinical settings when they have a severe neurological damage] Zbl Neurochir, 1955; 15:302\u2013305.","journal-title":"cerebri media als postoperative Komplikation. [Patients are considered neurologically non-recoverable in clinical settings when they have a severe neurological damage] Zbl Neurochir"},{"key":"e_1_3_7_7_2","first-page":"197","article-title":"Aneurysma einer basalen Gehirnarterie nach Trauma","volume":"19","author":"Jungmichel G.","year":"1932","unstructured":"Jungmichel G. Aneurysma einer basalen Gehirnarterie nach Trauma. [Aneurysm of a basal cerebral artery after trauma] Dtsch Z Gesamte Gerichtl Med, 1932; 19:197\u2013223.","journal-title":"[Aneurysm of a basal cerebral artery after trauma] Dtsch Z Gesamte Gerichtl Med"},{"key":"e_1_3_7_8_2","doi-asserted-by":"crossref","unstructured":"Mackenzie I. Intracranial Bruit. In: French's Index of Differential Diagnosis. Elsevier: London United Kingdom; 1979; pp. 432\u2013433.","DOI":"10.1016\/B978-0-7236-0490-7.50165-8"},{"issue":"1","key":"e_1_3_7_9_2","first-page":"3","article-title":"Traumatic pericallosal artery aneurysm","volume":"11","author":"Nov A","year":"1984","unstructured":"Nov A, , Cromwell L. Traumatic pericallosal artery aneurysm. J Neuroradiol, 1984; 11(1):3\u20138.","journal-title":"J Neuroradiol"},{"key":"e_1_3_7_10_2","first-page":"41","article-title":"A case of a ruptured intracranial aneurysm within the subdural space","volume":"17","author":"Nakamura N","year":"1965","unstructured":"Nakamura N, , Sato O. A case of a ruptured intracranial aneurysm within the subdural space. Brain Nerve, 1965; 17:41\u201345.","journal-title":"Brain Nerve"},{"key":"e_1_3_7_11_2","doi-asserted-by":"publisher","DOI":"10.1227\/00006123-198502000-00018"},{"key":"e_1_3_7_12_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF00337507"},{"key":"e_1_3_7_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0303-8467(89)80012-5"},{"key":"e_1_3_7_14_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF01418831"},{"issue":"2","key":"e_1_3_7_15_2","first-page":"181","article-title":"Delayed intracerebral hematoma due to traumatic aneurysm caused by a shotgun wound: a problem in prophylaxis","volume":"6","author":"Kaufman HH","year":"1980","unstructured":"Kaufman HH, , Sadhu VK, , Clifton GL, et al. Delayed intracerebral hematoma due to traumatic aneurysm caused by a shotgun wound: a problem in prophylaxis. Neurosurgery, 1980; 6(2):181\u2013184.","journal-title":"Neurosurgery"},{"issue":"5","key":"e_1_3_7_16_2","first-page":"405","article-title":"Traumatic aneurysms of cavernous internal carotid artery with secondary epistaxis","volume":"2","author":"Chambers EF","year":"1981","unstructured":"Chambers EF, , Rosenbaum AE, , Norman D, et al. Traumatic aneurysms of cavernous internal carotid artery with secondary epistaxis. Am J Neuroradiol, 1981; 2(5):405\u2013409.","journal-title":"Am J Neuroradiol"},{"key":"e_1_3_7_17_2","first-page":"607","article-title":"Aneurisma post-traumatico intracranico della carotide interna come causa di epistassi: considerazioni su due casi","volume":"10","author":"Gallina E","year":"1990","unstructured":"Gallina E, , Gallo O, , Boccuzzi S, et al. Aneurisma post-traumatico intracranico della carotide interna come causa di epistassi: considerazioni su due casi. Acta Otorhinolaryngol Ital, 1990; 10:607\u2013613.","journal-title":"Acta Otorhinolaryngol Ital"},{"issue":"4","key":"e_1_3_7_18_2","first-page":"360","article-title":"Massive epistaxis following closed head injury","volume":"102","author":"Hamilton J.","year":"1953","unstructured":"Hamilton J. Massive epistaxis following closed head injury. Guys Hosp Rep, 1953; 102(4):360\u2013367.","journal-title":"Guys Hosp Rep"},{"issue":"4","key":"e_1_3_7_19_2","first-page":"241","article-title":"Severe epistaxis caused by traumatic aneurysm of cavernous carotid artery","volume":"5","author":"Handa J","year":"1976","unstructured":"Handa J, , Handa H. Severe epistaxis caused by traumatic aneurysm of cavernous carotid artery. Surg Neurol, 1976; 5(4):241\u2013243.","journal-title":"Surg Neurol"},{"key":"e_1_3_7_20_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF01402536"},{"key":"e_1_3_7_21_2","first-page":"759","article-title":"Traumatic intracranial vascular lesions producing late massive nasal hemorrhage","volume":"65","author":"DF W","year":"1961","unstructured":"DF W, , EM G. Traumatic intracranial vascular lesions producing late massive nasal hemorrhage. Trans Am Acad Ophthalmol Otolaryngol, 1961; 65:759\u2013774.","journal-title":"Trans Am Acad Ophthalmol Otolaryngol"},{"key":"e_1_3_7_22_2","doi-asserted-by":"publisher","DOI":"10.1159\/000114835"},{"issue":"10","key":"e_1_3_7_23_2","first-page":"715","article-title":"Post-traumatic pseudo-aneurysm of the cerebral arteries","volume":"56","author":"Upuy JP","year":"1975","unstructured":"Upuy JP, , Ravon R, , Bokor J, et al. Post-traumatic pseudo-aneurysm of the cerebral arteries. J Radiol Electrol Med Nucl, 1975; 56(10):715\u2013716.","journal-title":"J Radiol Electrol Med Nucl"},{"key":"e_1_3_7_24_2","doi-asserted-by":"publisher","DOI":"10.1227\/00006123-199109000-00018"},{"key":"e_1_3_7_25_2","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1992.77.5.0799"},{"key":"e_1_3_7_26_2","doi-asserted-by":"publisher","DOI":"10.1227\/00006123-198502000-00016"},{"key":"e_1_3_7_27_2","doi-asserted-by":"publisher","DOI":"10.1288\/00005537-196711000-00001"},{"key":"e_1_3_7_28_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.36.1.127"},{"key":"e_1_3_7_29_2","doi-asserted-by":"publisher","DOI":"10.1227\/00006123-198707000-00019"},{"key":"e_1_3_7_30_2","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1973.38.5.0568"},{"key":"e_1_3_7_31_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF00335125"},{"key":"e_1_3_7_32_2","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.1991.00530170050020"},{"key":"e_1_3_7_33_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1042-3680(18)30432-7"},{"key":"e_1_3_7_34_2","doi-asserted-by":"publisher","DOI":"10.1016\/B978-0-444-52892-6.00012-X"},{"key":"e_1_3_7_35_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF01401153"},{"key":"e_1_3_7_36_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00381-006-0269-2"},{"issue":"1","key":"e_1_3_7_37_2","first-page":"258","article-title":"False cerebral aneurysm of the vertebral artery from remote missile injury of the neck","volume":"55","author":"Lunn GM.","year":"1947","unstructured":"Lunn GM. False cerebral aneurysm of the vertebral artery from remote missile injury of the neck. Br J Surg, 1947; 55(Suppl 1):258\u2013260.","journal-title":"Br J Surg"},{"key":"e_1_3_7_38_2","doi-asserted-by":"publisher","DOI":"10.1259\/0007-1285-53-636-1144"},{"key":"e_1_3_7_39_2","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.159.2.1632358"},{"key":"e_1_3_7_40_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2020.11.078"},{"key":"e_1_3_7_41_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12028-020-01106-y"},{"key":"e_1_3_7_42_2","doi-asserted-by":"publisher","DOI":"10.1227\/01.NEU.0000361285.50218.A8"},{"key":"e_1_3_7_43_2","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1972.36.4.0503"},{"issue":"2","key":"e_1_3_7_44_2","first-page":"233","article-title":"Cerebral aneurysms of traumatic origin","volume":"4","author":"Fleischer A","year":"1975","unstructured":"Fleischer A, , Patton J, , Tindall G. Cerebral aneurysms of traumatic origin. Surg Neurol, 1975; 4(2):233\u2013239.","journal-title":"Surg Neurol"},{"key":"e_1_3_7_45_2","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1984.60.1.0042"},{"key":"e_1_3_7_46_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.35.2.247"},{"issue":"3","key":"e_1_3_7_47_2","first-page":"233","article-title":"Wilder Penfield Lecture: nature and management of penetrating head injuries during the Civil War in Lebanon","volume":"21","author":"Haddad F.","year":"1978","unstructured":"Haddad F. Wilder Penfield Lecture: nature and management of penetrating head injuries during the Civil War in Lebanon. Can J Surg, 1978; 21(3):233\u2013240.","journal-title":"Can J Surg"},{"key":"e_1_3_7_48_2","doi-asserted-by":"publisher","DOI":"10.3171\/2014.9.JNS14679"},{"key":"e_1_3_7_49_2","doi-asserted-by":"publisher","DOI":"10.3171\/2014.7.JNS132688"},{"key":"e_1_3_7_50_2","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000000414"},{"key":"e_1_3_7_51_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2017.06.003"},{"key":"e_1_3_7_52_2","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A1261"},{"key":"e_1_3_7_53_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)30932-1"},{"key":"e_1_3_7_54_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.crad.2012.12.011"},{"key":"e_1_3_7_55_2","unstructured":"Aarabi B Taghipour M Kamgarpour A. Traumatic Intracranial Aneurysms due to Craniocerebral Missile Wounds. In: Missile Wounds of Head and Neck. American Association of Neurological Surgeons: Lebanon NH; 1999; pp. 293\u2013314."},{"key":"e_1_3_7_56_2","first-page":"1227","article-title":"Association of Cerebrovascular Injury and Secondary Vascular Insult With Poor Outcomes After Gunshot Wound to the Head in a Large Civilian Population","volume":"10","author":"Lamanna JJ","year":"2022","unstructured":"Lamanna JJ, , Gutierrez J, , Alawieh A, et al. Association of Cerebrovascular Injury and Secondary Vascular Insult With Poor Outcomes After Gunshot Wound to the Head in a Large Civilian Population. Neurosurgery, 2022; 10:1227.","journal-title":"Neurosurgery"},{"key":"e_1_3_7_57_2","unstructured":"Von Hanwehr R Giannotta S Weiss M et al. The Impact of Traumatic Cerebral Aneurysms and their Sequelae on Selective Morbidity Following Head Trauma. In: Intracranial Aneurysms: Surgical Timing and Techniques. Nishimura: Tokyo; 1986; pp. 96\u2013104."}],"container-title":["Journal of Neurotrauma"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1089\/neu.2023.0576","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/neu.2023.0576","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/neu.2023.0576","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T22:44:49Z","timestamp":1777675489000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1089\/neu.2023.0576"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8]]},"references-count":56,"journal-issue":{"issue":"15-16","published-print":{"date-parts":[[2024,8]]}},"alternative-id":["10.1089\/neu.2023.0576"],"URL":"https:\/\/doi.org\/10.1089\/neu.2023.0576","relation":{},"ISSN":["0897-7151","1557-9042"],"issn-type":[{"value":"0897-7151","type":"print"},{"value":"1557-9042","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,8]]}}}