Traumatic brain injury is often associated with a direct or secondary neurovascular pathology. In this review, we present recent advancements in endovascular neurosurgery that enable accurate and effective vessel reconstruction with emphasis on its role in early diagnosis, the expanding use of flow diversion in pseudoaneurysms, and traumatic arteriovenous fistulas. In addition, future directions in which catheter-based interventions could potentially affect traumatic brain injury are described: targeting blood brain barrier integrity using the advantages of intra-arterial drug delivery of blood brain barrier stabilizers to prevent secondary brain edema, exploring the impact of endovascular venous access as a means to modulate venous outflow in an attempt to reduce intracranial pressure and augment brain perfusion, applying selective intra-arterial hypothermia as a neuroprotection method mitigating some of the risks conferred by systemic cooling, trans-vessel wall delivery of regenerative therapy agents, and shifting attention using multimodal neuromonitoring to post-traumatic vasospasm to further characterize the role it plays in secondary brain injury. Thus, we believe that the potential of endovascular tools can be expanded because they enable access to the "highways" governing perfusion and flow and call for further research focused on exploring these routes because it may contribute to novel endovascular approaches currently used for treating injured vessels, harnessing them for treatment of the injured brain.

中文翻译：

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神经外伤的神经血管干预：从治疗受伤的血管到治疗受伤的大脑？

创伤性脑损伤通常与直接或继发性神经血管病理有关。在这篇综述中，我们介绍了血管内神经外科的最新进展，这些进展能够实现准确有效的血管重建，重点是其在早期诊断中的作用、血流改道在假性动脉瘤和创伤性动静脉瘘中的广泛使用。此外，还描述了基于导管的干预措施可能影响创伤性脑损伤的未来方向：利用血脑屏障稳定剂的动脉内药物输送的优势，以血脑屏障完整性为目标，以预防继发性脑水肿，探索血管内治疗的影响静脉通路作为调节静脉流出的手段，试图降低颅内压和增加脑灌注，应用选择性动脉内低温作为神经保护方法，减轻全身冷却、跨血管壁输送再生治疗药物带来的一些风险，并使用多模式神经监测将注意力转移到创伤后血管痉挛，以进一步表征其在继发性脑损伤中所起的作用。因此，我们相信血管内工具的潜力可以扩大，因为它们能够进入控制灌注和血流的“高速公路”，并呼吁进一步研究重点探索这些路线，因为它可能有助于目前用于治疗受损血管的新型血管内方法，利用它们来治疗受伤的大脑。