Endovascular Repair of a Middle Meningeal Artery Aneurysm after Cranial Surgery

Abstract

This report describes a case of middle meningeal artery aneurysm caused after cranial surgery. A 55-year-old woman who experienced a ruptured internal carotid artery anterior wall aneurysm was treated by internal carotid artery trapping and high-flow bypass using a radial artery graft. Eight days after surgery, we performed cerebral angiography to confirm patency of the radial artery graft and discovered a middle meningeal artery aneurysm, which was not identified in preoperative angiography. The aneurysm was treated by endovascular embolization using n-butyl cyanoacrylate and complete obliteration was confirmed by angiography. This middle meningeal artery aneurysm was associated with prior surgical procedures, particularly craniotomy or dural tenting sutures. Our study suggests that middle meningeal artery aneurysms can be a rare complication associated with brain surgery. Endovascular embolization using a liquid material may provide an effective and safe treatment for such cases.

Case report: An overlooked complication of the dural suture after craniotomy: pseudoaneurysm of the middle meningeal artery with endovascular resolution

“…A previous study described an MMA pseudoaneurysm following internal carotid artery trapping and high-flow bypass with a radial artery graft (10). Another study presented an iatrogenic pseudoaneurysm of the MMA after installation of an external ventricular drain (11).…”