Traumatic Intracranial Pseudoaneurysms Research Articles

Traumatic Intracranial Pseudoaneurysm Treated with Flow Diverters: Case Report and Meta-Analysis

BACKGROUNDIt is controversial to treat traumatic intracranial pseudoaneurysms (TIPAs) with flow diverters (FDs). We present an 18-year-old girl who underwent a TCCF of ruptured TIPA treated with flow-diverters, and then report the results of the largest meta-analysis aimed to evaluate the safety and effectiveness of flow diversions in this situation. METHODSA systematic search of Web of Science databases, Embase, and PubMed was performed for articles published between 2010 and Sep 2022. According to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, studies reporting FD for TIPA with ≥3 patients were included. Weassessedthecomplete occlusion rate, complicationsrelatedtothe operation, and clinical outcome. Ameta-analysisbased onheterogeneitywascarriedoutusing random or common effectsmodels. RESULTSWe included 7 non-comparative studies with a total of 58 target TIPAs. 17 aneurysms were explicitly described as being ruptured. All FDs were successfully released. Overall, 5 (8.6%) aneurysms were treated with overlapped diverters. During a mean angiographic follow-up of 17.3 months, the complete occlusion rate was 86.0% (46/56; 95% CI, 74%–95%; I2=7%; P=0.37). The operate-related complications rate was 9% (95% CI=1–23%; I2=0.00%; P=0.52). Two patients died of non-aneurysmal hemorrhage. The percentageofgoodclinical outcome was 85.7% (95% CI=78–98%; I2=23.7%; P=0.25) at the last follow-up. CONCLUSIONFD provides significant advantages in the treatment of TIPA. Nevertheless, operation-related complications are not negligible. Additional prospective and randomized investigations are needed to determine the long-term effects of FD on TIPA.

Abstract Number ‐ 84: Importance of Early Detection and Treatment of Traumatic Intracranial Pseudoaneurysms Prior to Decompressive Hemicraniectomy

Introduction Intracranial pseudoaneurysms are rare lesions that represent less than 1% of all intracranial aneurysms.1They typically occur due to disruption of the arterial wall layers and subsequent extramural/extraluminal hematoma formation following traumatic brain injury, resulting in a higher risk of rebleeding than that of saccular cerebral aneurysms.2Pseudoaneurysms have higher incidence in children and young adults, and given their association with high morbidity and mortality, early detection and management is essential.2‐4The purpose of this study is to highlight the importance of early recognition and management of traumatic pseudoaneurysms prior to decompressive hemicraniectomy. Methods This is a case report of a six‐year‐old previously healthy male who presented as a level 1 trauma alert after sustaining a gunshot wound to the face while manipulating an unsecured weapon at his residence. Upon arrival, lack of airway protection requiring intubation, entry wound to the anterior forehead, and diffuse forehead and periorbital edema were observed. CT head demonstrated multicompartmental hemorrhage with 6mm right to left midline shift and diffuse cerebral edema. CTA head and neck noted possible thrombosed right anterior cerebral artery (ACA) pseudoaneurysm in the right frontoparietal region (Figure 1‐A). Prior to decompressive hemicraniectomy, neuro‐endovascular consultation was obtained, and emergent cerebral angiogram was recommended. This case highlights the findings demonstrated on cerebral angiography, the technique by which the pseudoaneurysm was detected and secured, and the importance of doing so prior to further neurosurgical interventions. Results The patient was taken for diagnostic cerebral angiogram via femoral artery access. Initial angiographic run of the right internal carotid artery demonstrated distal right pericallosal artery slowing without clear evidence of underlying vascular injuries. Given concern for underlying thrombosed pseudoaneurysm and its parent branch, selective catheterization of the proximal pericallosal artery off the distal ACA was performed. Gentle angiographic run was obtained via microcatheter that demonstrated superior parietal artery pseudoaneurysm without active extravasation (Figure 1‐B). The microcatheter was advanced and placed in the proximal portion of the pseudoaneurysm sac and five platinum coils were deployed to fully obliterate the pseudoaneurysm and its parent feeder while protecting the adjacent paracentral artery (Figure 1‐C, 1‐D). Following completion of the endovascular procedure, the patient was transferred to the operative room for right decompressive hemicraniectomy and clot evacuation, which were completed successfully. Conclusions Prompt detection and securement of traumatic intracranial pseudoaneurysms are essential prior to invasive neurosurgical interventions to reduce risk of recurrent bleeding. Selective angiographic evaluation of the parent injured vessel(s) is crucial for optimal assessment of the underlying lesion. Neuro‐endovascular interventions including coil embolization, stenting, flow‐diverter implantation, and parental artery occlusion have emerged as alternatives to conventional neurosurgical management.2 This case highlights the successful early detection and treatment of a traumatic intracranial pseudoaneurysm with coil embolization followed by uncomplicated decompressive hemicraniectomy.

Multiple Stenting without Coils for Traumatic Pseudoaneurysm of Supraclinoid Internal Carotid Artery: Two Case Reports

Traumatic intracranial pseudoaneurysm (TIPA) is a very rare disease that is difficult to diagnose and treat and has high mortality and morbidity. Various treatment methods, such as microsurgery and endovascular treatment, have been proposed because TIPA accompanies traumatic brain injury. It is necessary to consider the location and characteristics of the TIPA and the patient's condition. According to previous reports regarding the endovascular treatment of TIPA, most cases were treated with stent-assisted coil embolization. Unlike previous studies, however, we would like to share our experience of two cases successfully treated by overlapping three closed-cell self-expandable stents without coils.

Traumatic intracranial aneurysms associated with traffic accidents and endovascular management options

Traumatic intracranial pseudoaneurysms are rare complications of head injuries following traffic accidents, occurring in less than 1% of all cerebral aneurysms. Most cases are associated with fracture of the skull. Rupture of these traumatic aneurysms occur in up to 50% of all cases and are typically delayed from days to weeks following the initiating trauma. Traumatic pseudoaneurysms are often called a pulsating hematoma, which occurs when the arterial wall is ruptured by trauma and bleeding is confined only by the adventitia or surrounding tissues. Unlike the structure of a true aneurysm, that has all anatomical layers, the wall of a traumatic intracranial pseudoaneurysm is composed mainly of blood clot and a small amount of fibrous tissue. Difficult diagnosis, delayed presentation and poor outcomes contribute to overall prognosis of these traumatic intracranial aneurysms.
 We investigated the patients with traumatic intracranial aneurysms developed after traffic accidents and treated with endovascular embolization in our Institution, with a review of literature and discussion of management options.
 As traumatic intracranial aneurysms may present both diagnostic challenges and surgical difficulties, especially after polytrauma cases, rarely being appropriate for conservative treatment, early and precise diagnosis with cerebral angiography and prompt treatment are essential for good prognosis. Due to its nature to be fragile and prone to rupture, careful and precise endovascular embolization is thus a method of choice for treatment of these pseudoaneurysms.

Low-profile visualized intraluminal support stent for the endovascular treatment of traumatic intracranial internal carotid artery pseudoaneurysms.

Optimal treatment strategies for traumatic intracranial internal carotid artery (ICA) pseudoaneurysms are controversial. The low-profile visualized intraluminal support (LVIS) device is a braided stent with a metal coverage rate between traditional laser cut stents and flow diversion devices. We report here our therapy strategy using the LVIS stent-assisted coiling for treatment of traumatic intracranial ICA pseudoaneurysms. Patients with traumatic intracranial ICA pseudoaneurysms treated by the LVIS stent-assisted coiling in our center between January 2015 and June 2021 were reviewed. The complications, radiographic, and clinical outcomes of these patients were analyzed. A total of 12 patients with 12 pseudoaneurysms were included. The mean maximum aneurysm diameter was 6.2 ± 3.1mm. Nine patients had a subarachnoid hemorrhage; five patients with Hunt-Hess grade III and four patients with grade IV. All procedures were successfully performed without intraoperative complications. Immediate postoperative angiogram showed that six (50%) aneurysms were Raymond grade 1, four (33.3%) were grade 2, and two (16.7%) were grade 3. Postoperative multiple cerebral infarction occurred in two patients because of vasospasm. Of the ten patients with angiographic follow-up (mean, 29.9months), two received additional coiling because of recanalization of the pseudoaneurysm, and all aneurysms were completely obliterated at the last examination of the patients. During the clinical follow-up period (mean, 26.8months), the overall mortality and morbidity were 25% (3/12) and 8.3% (1/12), respectively. LVIS stent-assisted coiling was a feasible approach for the treatment of traumatic ICA pseudoaneurysms.

Treatment of Traumatic Intracranial Pseudoaneurysms: A Single-Center Experience.

Background and Purpose: As a rare lesion secondary to brain trauma, traumatic intracranial aneurysms (TICAs) lead to high mortality and morbidity, and multiple treatment modalities have been applied for TICAs. All patients diagnosed with TICAs in our institution from 2010 to 2020 were included in the report, and their clinical features, treatment, and outcomes are described in detail. The purpose of this study is to illustrate the characteristic of different therapeutic methods of TICAs, and focus on the endovascular treatment.Methods: A total of 20 patients were included in this study. The 3 patients who declined treatment all died. Five of the other 17 patients were treated surgically, including clipping, wrapping, and trapping with or without EC-IC high-flow bypass, with only 1 case of parent artery preservation. Twelve patients underwent endovascular treatment, including bare coil embolization (1 case), stent-assisted coiling (2 cases), balloon-assisted coils/Onyx glue embolization (1 case) and covered stents (8 cases), with only 1 case of parent artery sacrifice.Results: 20 patients were included in the present study with 17 males, and the mean of age on 27 years (IQR: 22, 44 years). Eight patients presented with epistaxis, followed by 5 patients with coma, 3 patients with visual defects and 2 patients with CSF leakage. There were 18 TICAs located at the internal carotid artery (ICA); The other 2 TICAs located at pericallosal artery and A1 segment anterior cerebral artery (ACA). One case of diplopia occurred due to sacrifice of the ICA. Occlusion of the ophthalmic artery occurred in 3 patients after placement of a covered stent, with 1 patient suffering an irreversible vision decrease. None of the other patients who underwent the treatment have experienced an aggravation of their symptoms since the treatment; During the imaging follow-up, 1 case of recurrence and 1 case of endoleak occurred in this case series.Conclusions: TICAs are associated with significant morbidity and mortality, and endovascular treatment has emerged as a valuable option, which may be promising to improve the clinical outcomes due to their advantages of preserving the parent artery if occlusion of the side branch artery can be avoided.

Traumatic intracranial internal carotid artery dissection and pseudoaneurysm presenting as oculomotor nerve palsy

Traumatic intracranial internal carotid artery dissection and pseudoaneurysm presenting as oculomotor nerve palsy

Diagnosis and treatment differences between iatrogenic and traumatic intracranial pseudoaneurysms

Objective To investigate the differences in the diagnosis and treatment between iatrogenic intracranial pseudoaneurysms (II-PSAN) and traumatic intracranial pseudoaneurysms (TI-PSAN). Methods In this retrospective study, 11 patients with intracranial PSAN admitted to the Department of Neurosurgery of Huashan Hospital Affiliated to Fudan University between January 2013 and December 2017 were enrolled. Among those 11 cases, TI-PSAN was diagnosed in 9 cases and II-PSAN in 2. In the 9 TI-PSAN cases, there were 11 PSAN including 7 undergoing embolization treatment (PSAN and parent artery), 2 receiving revascularization (stent and Guglielmi detachable coil placement in 1 and double stents placement in 1), 1 undergoing surgery and the other 1 receiving no treatment. For the 2 cases with II-PSAN, 1 received embolotherapy and 1 received revascularization using LVIS stent and GDC. At the follow-up, the DSA, CTA or MRI was performed to evaluate the recurrence and residue of PSAN and assess the outcomes by using the modified Rankin score (mRS). Results Among the 13 PSAN of 11 patients, 12 showed satisfactory outcomes after surgery. One TI-PSAN patient died from intracranial hemorrhage at 1 day post surgery and no postoperative hemorrhage was reported in the other 10 cases. The 10 cases were followed up for 1-36 months, with an average of 13 months. Among them, 6 received DSA in the follow-up and the other 4 received CTA or MRA in the follow-up. Among 8 cases with TI-PSAN, no revascularization or recurrence of PSAN was reported in the 6 cases undergoing embolization and the vascular compensation was satisfactory. In the other 2 cases undergoing revascularization, 1 showed no residual or recurrent PSAN and 1 showed residue in the aneurysm neck. In the 2 II-PSAN cases, there was no residual or recurrent PSAN. Eight TI-PSAN cases showed the mRS score of 0-2 and 2 cases with II-PSAN showed the mRS score of 0. The outcomes were all good. Conclusions Unlike TI-PSAN, the symptoms of II-PSAN are not typical. Thus, much attention should be paid to the diagnosis of II-PSAN. For the II-PSAN patients or TI-PSAN patients with mild vascular injury and good integrity, vascular reconstruction is preferred. For PSAN patients with poor vascular integrity and compliance to reconstruction, occlusion of PSAN combined with vascular bypass surgery should be considered in advance. Key words: Intracranial pseudoaneurysm; Iatrogenesis; Traumatism; Diagnosis; Endovascular treatment; Difference

Anchoring Pipeline Flow Diverter Construct in the Treatment of Traumatic Distal Cervical Carotid Artery Injury

Background: Traumatic extracranial internal carotid artery (ICA) dissections are uncommon and can be difficult to treat. Thinning of adventitia and dilatation may occur following arterial dissection, thus resulting in a fusiform pseudoaneurysm, which can subsequently cause bleeding, expanding, or pulsatile hematoma. Currently, medical management with anticoagulation remains the first line of treatment and yields good outcomes in 75% of cases with a mortality rate of 3-4%. Endovascular intervention is indicated with failure of medical therapy, progressive enlargement of a traumatic pseudoaneurysm, acute flow-related infarcts due to vessel occlusion, or when anticoagulation is contraindicated due to risk of pseudoaneurysm rupture and hemorrhage. Recognized interventional treatments include parent artery occlusion with or without revascularization, endovascular coil embolization, and covered stenting. Summary: A wide variety of endovascular stents are available that are capable of opening a stenosed vessel while obliterating the associated false lumen and providing a scaffold for embolization of the pseudoaneurysm. The use of the Pipeline Embolization Device (PED) in the management of traumatic intracranial pseudoaneurysms has been described. However, there are few reports on the usage of the PED for treating traumatic extracranial ICA dissection and/or pseudoaneurysms. However, a potential complication of the use of PED in the extracranial ICA is a hypothetical tendency to migrate in a mobile vessel. Thus, the risk of migration of the PED has encouraged practitioners to adopt strategies to limit this risk. Key Messages: We describe different techniques employed to anchor the flow-diverting construct within tortuous, mobile vessels.

Endovascular treatment of traumatic intracranial pseudoaneurysms

Objective To investigate the application and clinical efficacy of endovascular treatment in traumatic intracranial pseudoaneurysms. Methods The clinical data of 21 patients with traumatic intracranial pseudoaneurysms treated with endovascular treatment at the Department of Neurosurgery, Beijing Chaoyang Hospital, Capital Medical University from December 2006 to June 2015 were analyzed retrospectively. All 21 patients were treated with endovascular treatment, including 3 patients were treated with simple coil embolization, 10 were treated with stent-assisted coil embolization, and 8 were treated with covered stent placement. The follow-up time ranged from 3 to 24 months. Results In 21 patients with pseudoaneurysm except 1 died, the remaining 20 were occluded completely, and they were followed up. The modified Rankin scale(mRS)score 0 was in 13 cases and the mRS score 1 was in 7 cases. In 8 patients treated with covered stents, postoperative angiography immediately after procedure suggested that all the aneurysms did not develop. One patient showed distal in-stent stenosis during the reexamination, however, he did not have any symptom. The other 7 patients did not have recurrence and other complications. Of the 3 patients treated with the simple coil embolization, the aneurysms of 2 cases were occluded completely; the aneurysm of 1 case recurred. After being treated with stent-assisted coil embolization, the result was satisfactory. He was reexamined and did not find recrudescence. Of the 10 patients treated with stent-assisted coil embolization, all the embolizations were satisfactory, 1 died of aneurysm rupture after procedure. The remaining 9 cases were followed up and no recurrence was observed. Conclusion Endovascular treatment may achieve safe and effective treatment outcomes through a reasonable choice of surgical options for the treatment of traumatic intracranial pseudoaneurysms. Key words: Intracranial aneurysm; Pseudoaneurysm; Endovascular procedures; Stents

The unusual angiographic course of intracranial pseudoaneurysms

Although rare, traumatic intracranial pseudoaneurysms remain one of the most difficult vascular lesions to diagnose and treat. A 55-year-old male patient underwent endoscopic endonasal transphenoidal resection for a pituitary macroadenoma. The operation was complicated by an arterial bleed. The initial angiogram revealed pseudoaneurysm of the anterior choroidal artery. Although the pseudoaneurysm completely disappeared on the second angiogram, it was surprisingly found to have enlarged on the third angiogram. The lesion was successfully treated with flow-diversion using a pipeline embolization device. The present case demonstrates that the natural history of iatrogenic pseudoaneurysms may be unpredictable and misleading. Traumatic pseudoaneurysms should, therefore, be carefully followed when conservative treatment is elected or when the lesion seems to have spontaneously regressed. Flow-diversion seems to be a reasonable treatment option.

Clinical Analysis of Traumatic Cerebral Pseudoaneurysms.

ObjectiveTraumatic pseudoaneurysms are rare but life-threatening lesions. We investigated the patients with these lesions to clarify their clinical characteristics and therapeutic strategies and we also reviewed the literatures on the treatment principles, possible options, and outcomes.MethodsThere were a total of 8 patients who were treated with traumatic intracranial pseudoaneurysms between April 1980 and January 2009. Medical charts and the imaging studies were reviewed for analysis. The outcome was measured with modified Rankin Scale (mRS) score at 6 months after treatment.ResultsAll 8 patients were male and the mean age was 25 years old. Six of those were located at the cavernous segment of the internal carotid artery (ICA) and the other 2 was located at the M2 segment of middle cerebral artery. The causes of trauma were car accidents in 6, penetrating injury through the orbit in 1, and slip down injury in 1 patient. Massive epistaxis or hematemesis occurred in all patients with a pseudoaneurysm at the cavernous and ophthalmic segment of the ICA. All 6 patients of the cavernous and ophthalmic ICA group showed favorable outcome of mRS 0 to 1. The outcome of patients with middle cerebral artery pseudoaneurysm was mRS 2 to 3.ConclusionUpon prompt diagnosis and proper treatment planning, it is possible to achieve favorable outcome in these patients. Lesions located at the cavernous segment of the ICA favored endovascular treatment while those at the middle cerebral artery favored surgical treatment.

Intracranial pseudoaneurysm after intracranial pressure monitor placement

Traumatic intracranial pseudoaneurysms are a rare but severe complication following arterial injury. Pseudoaneurysm formation can occur secondary to blunt or penetrating trauma or iatrogenic injury. We report a case of...

A Rare Case of Posterior Communicating Artery Pseudoaneurysm Caused by Traumatic Head Injury

Traumatic intracranial aneurysm is rare and mostly due to blunt head injury. High mortality rate up to 50% is reported in the literature. Early diagnosis and appropriate management is essential for this fatal disease. We present a rare case of pseudoaneurysm over left-side posterior communicating artery after traumatic head injury. Avulsion of the posterior communicating artery was noted intra-operatively and then clipping of the proximal stump was arranged. There was no delayed hemorrhage after the operation. After review of the literature, there is no definite management for this kind of traumatic intracranial pseudoaneurysm. Here, we present the fourth case of posterior communicating artery traumatic pseudoaneurysm, which presents appropriate outcome after surgical intervention of clipping proximal stump of the avulsed artery.

Delayed Cavernous Carotid Artery Pseudoaneurysm Caused by Absorbable Plate Following Transsphenoidal Surgery: Case Report and Review of the Literature

Background Bioabsorbable plates are frequently utilized in the repair of skull base defects following transsphenoidal operations. Traumatic intracranial pseudoaneurysms are a rare complication of transsphenoidal surgery. To date, iatrogenic carotid pseudoaneurysm associated with the use of an absorbable plate has been reported once.Results A 57-year-old man with a large nonfunctional pituitary macroadenoma underwent an endoscopic transsphenoidal operation with gross total resection. An absorbable plate was placed extradurally to reconstruct the sellar floor. He experienced delayed repeated epistaxis, followed by a right middle cerebral artery distribution embolic stroke. Computed tomorgraphy (CT) angiogram 6 weeks postoperatively revealed a 6 × 4 mm pseudoaneurysm located on the medial wall of the right cavernous internal carotid artery. Stent coiling was used to successfully obliterate the pseudoaneurysm, and the patient fully recovered.Conclusion Delayed erosion of the carotid artery wall caused by a plate used to reconstruct the sellar floor may manifest with epistaxis or embolic stroke. The authors' preference is to avoid insertion of a rigid plate for sellar floor reconstruction in the absence of intraoperative cerebrospinal fluid (CSF) leaks, unless it is required to buttress a large skull base defect. Short-segment embolization with stent coiling is the preferred treatment option for carotid pseudoaneurysms following transsphenoidal operations.

Stent Coil Embolization of an Iatrogenic Cavernous Carotid Pseudoaneurysm

Background: Absorbable plates have recently become more frequently used in the repair of skull base cranial defects following endonasal operations. Traumatic intracranial pseudoaneurysms have been reported secondary to placement of these plates, often requiring endovascular intervention. Previous treatment of these pseudoaneurysms has been deconstructive with endovascular versus open carotid sacrifice.

Successful treatment of a traumatic carotid pseudoaneurysm with the Pipeline stent: Case report and review of the literature

Background:Traumatic intracranial pseudoaneurysms remain one of the most difficult vascular lesions to treat. In the case of traumatic pseudoaneurysms that may not be treated with parent vessel sacrifice, some flow diversion strategy such as stent-assistance or use of a flow diversion device is usually necessary.Case Description:In this study we describe endovascular parent vessel wall-remodeling/endoluminal reconstruction and traumatic pseudoaneurysm thrombosis through the use of the Pipeline stent and review recent reports concerning indications, safety, and efficacy for alternative pathology.Conclusion:Although currently not routinely employed in the treatment of traumatic pseudoaneurysms, the Pipeline stent may represent a safe and effective treatment alternative achieving complete endoluminal reconstruction of the damaged vessel wall.

Reconstructive stent-buttressed coil embolization of a traumatic pseudoaneurysm of the supraclinoid internal carotid artery

It is critical that traumatic intracranial pseudoaneurysms should be removed completely from the parent artery because there is a possibility of significant morbidity and mortality from the high risk of rebleeding from any remnants of the pseudoaneurysm. However, the deconstruction of the parent artery has the risk of ischemic damage to the distal to the trapped artery. We describe a case of a successful reconstructive stent-buttressed coil embolization in a patient with a traumatic pseudoaneurysm of the intracranial internal carotid artery. A 30-year-old man with a stuporous mentality was admitted to our institution after a traffic accident. The initial computed tomography scan showed a diffuse subarachnoid hemorrhage and a pseudoaneurysm of the left supraclinoid internal carotid artery. A reconstructive endovascular treatment using stent-assisted coil embolization with a stent-within-a-stent technique was conducted in order to save carotid blood flow. The pseudoaneurysm was completely obliterated and the patient recovered without any neurological deficit. We suggest that multiple stent placements with coiling may be considered as a treatment option for intracranial traumatic pseudoaneurysms as a reconstructive treatment.

Parent vessel occlusion for traumatic pseudoaneurysm of P3 segment of posterior cerebral artery: A case report and review of literatures

Traumatic intracranial pseudoaneurysms (TIPA) are rare and pseudoaneurysm of P3 segment of the posterior cerebral artery (PCA) is extremely rarely reported. A 27-year-old man suffered from blunt head injury and underwent diagnostic procedure with head CT scans, cerebral CT angiograms (CTA) and digital subtraction angiograms (DSA). An abnormal high-density lesion was detected at the left side of quadrigeminal cistern and a pseudoaneurysm showed at the P3 segment of PCA. The pseudoaneurysm was successfully treated with parent artery occlusion (PAO). Making an exact preoperative diagnosis of traumatic intracranial pseudoaneurysms is of great importance. Endovascular techniques allow a safe approach to complex intracranial lesion, so endovascular management of PCA pseudoaneurysms becomes safe and effective. However, the pseudoaneurysm may not be amenable to coil placement under some conditions, thus, occlusion of the parent vessel may be a preferable treatment.

Endovascular internal trapping of traumatic pericallosal pseudoaneurysm with hydrogel-coated self-expandable coil in a child: a case report

Background Traumatic intracranial pseudoaneurysms in children must be completely secured from the parent artery because of significant morbidity and mortality from the high risk of rebleeding. However, the trapping of the parent artery involves the risk of ischemia changes distal to the trapped artery and the perforator injury. We describe a first case in the literature of successful trapping in the short segment with hydrogel-coated self-expandable coil in a child with a traumatic pericallosal pseudoaneurysm. Case Description A 5-year-old boy was admitted to our institution after enduring a blunt trauma with a stuporous mentality. Initial neuroimaging revealed a small hemorrhage in the corpus callosum with subarachnoid hemorrhage. Two weeks later, computed tomogram showed new callosal hemorrhage and a 4.7 × 5-mm pseudoaneurysm of the right pericallosal artery with mental deterioration and weakness of lower extremity. An endovascular short segmental internal trapping (5 mm) of the right pericallosal artery was conducted to save collateral blood flow, using 2 hydrogel-coated self-expandable coils. The cerebral angiogram of immediately after the trapping and at 3 months' follow-up revealed that the aneurysm had been completely obliterated, with successful maintenance of the distal collateral flow from the contralateral pericallosal artery. The patient recovered with good clinical outcome. Conclusion We suggest that short-segment occlusion by a hydrogel-coated self-expandable coil has become a good alternative for the treatment of traumatic pseudoaneurysms in the distal anterior cerebral artery, although the safety and reliability of this procedure is as yet not definitely proven.