Incidental traumatic pseudoaneurysm of the middle meningeal artery- case report and literature review.

Nayil, Khursheed; Ramzan, Altaf; Makhdoomi, Rumana; Wani, Abrar Ahad; Zargar, Javeed; Shaheen, Feroze

doi:10.5137/1019-5149.jtn.3165-10.1

Cited by 6 publications

(18 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…"True" aneurysms do occur in the MMA, with the same histological characteristics as aneurysms of cerebral arteries, both in the context of trauma and in diseases that put increased hemodynamic stress on the wall of the artery, such as Paget's disease, dural arteriovenous malformations, moyamoya disease, and meningiomas. 18 Pseudoaneurysms of the MMA, although rare, may produce abrupt neurological deterioration due to rapid enlargement of an EDH, after a 3-to 30-day interval. 14,30 Nowadays, these vascular lesions may be missed due to the widespread use of CT scans in the evaluation of trauma.…”

Section: Discussionmentioning

confidence: 99%

Endovascular management of acute epidural hematomas: clinical experience with 80 cases

Peres¹,

Caldas²,

Puglia³

et al. 2018

Journal of Neurosurgery

View full text Add to dashboard Cite

OBJECTIVE Small acute epidural hematomas (EDHs) treated conservatively carry a nonmeasurable risk of late enlargement due to middle meningeal artery (MMA) lesions. Patients with EDHs need to stay hospitalized for several days, with neurological supervision and repeated CT scans. In this study, the authors analyzed the safety and efficacy of the embolization of the involved MMA and associated lesions. METHODS The study group consisted of 80 consecutive patients harboring small- to medium-sized EDHs treated by MMA embolization between January 2010 and December 2014. A literature review cohort was used as a control group. RESULTS The causes of head injury were falls, traffic-related accidents (including car, motorcycle, and pedestrian vs vehicle accidents), and assaults. The EDH topography was mainly temporal (lateral or pole). Active contrast leaking from the MMA was seen in 57.5%; arteriovenous fistulas between the MMA and diploic veins were seen in 10%; and MMA pseudoaneurysms were found in 13.6% of the cases. Embolizations were performed under local anesthesia in 80% of the cases, with N-butyl-2-cyanoacrylate, polyvinyl alcohol particles, or gelatin sponge (or a combination of these), obtaining MMA occlusion and complete resolution of the vascular lesions. All patients underwent follow-up CT scans between 1 and 7 days after the embolization. In the 80 cases in this series, no increase in size of the EDH was observed and the clinical evolution was uneventful, without Glasgow Coma Scale score modification after embolization and with no need for surgical evacuation. In contrast, the control cohort from the literature consisted of 471 patients, 82 (17.4%) of whom shifted from conservative treatment to surgical evacuation. CONCLUSIONS This study suggests that MMA embolization is a highly effective and safe method to achieve size stabilization in nonsurgically treated acute EDHs.

show abstract

Section: Discussionmentioning

confidence: 99%

Endovascular management of acute epidural hematomas: clinical experience with 80 cases

Peres¹,

Caldas²,

Puglia³

et al. 2018

Journal of Neurosurgery

View full text Add to dashboard Cite

show abstract

“…Discussão O primeiro caso de aneurisma traumático da AMM foi relatado por Schulze em 1957. 3 A formação desses aneurismas está associada principalmente ao TCE 2,5,6,8 e, nessas situações, as fraturas cranianas podem ser encontradas em até 92% dos casos. 2,6,8 Na maioria dos casos as fraturas cranianas são encontradas cruzando o trajeto da AMM, causando lesão da parede arterial com consequente formação do pseudoaneurisma.…”

Section: Figura 3 -(A-b) Microcateterismo Do Pseudoaneurisma Com Preeunclassified

“…3 A formação desses aneurismas está associada principalmente ao TCE 2,5,6,8 e, nessas situações, as fraturas cranianas podem ser encontradas em até 92% dos casos. 2,6,8 Na maioria dos casos as fraturas cranianas são encontradas cruzando o trajeto da AMM, causando lesão da parede arterial com consequente formação do pseudoaneurisma. [2][3][4][5][6]8,9 Cerca de 85% dos aneurismas traumáticos são encontrados na região temporal, 6 10% na occipital e 5% na região frontal.…”

Section: Figura 3 -(A-b) Microcateterismo Do Pseudoaneurisma Com Preeunclassified

“…O pseudoaneurisma pós-traumático da artéria meníngea média (AMM) representa lesão rara, [1][2][3][4][5][6] correspondendo a menos de 1% dos aneurismas intracranianos. 2,3 Tais lesões estão associadas principalmente a fraturas cranianas traumáticas, [7][8][9] possuindo altas taxas de mortalidade.…”

Section: Introductionunclassified

“…2,3 Tais lesões estão associadas principalmente a fraturas cranianas traumáticas, [7][8][9] possuindo altas taxas de mortalidade. 1,2,4,6 O hematoma extradural é a apresentação precoce ou tardia mais comum desse tipo de lesão, 8 podendo estar associado também a hematoma subdural ou hemorragia subaracnóidea. 2,3 O objetivo do presente artigo é apresentar o caso de um paciente vítima de traumatismo craniano que desenvolveu pseudoaneurisma da AMM, sendo submetido a tratamento endovascular com sucesso.…”

Section: Introductionunclassified

See 2 more Smart Citations

Pseudoaneurisma traumático da artéria meníngea média tratado por via endovascular

Neto¹,

Aguiar²,

Veiga³

et al. 2013

Arq Bras Neurocir

View full text Add to dashboard Cite

ResumoOs pseudoaneurismas traumáticos da artéria meníngea média (AMM) representam lesões raras, correspondendo a menos de 1% dos aneurismas intracranianos. Em geral, estão associados à fratura craniana temporal que cruza o trajeto da AMM. O hematoma extradural (HED) é a apresentação mais comum desse tipo de lesão, podendo apresentar elevada morbimortalidade na maioria dos casos. O diagnóstico dos pseudoaneurismas da AMM pode ser realizado por angiorressonância, angiotomografia e, principalmente, por arteriografia cerebral. Após a confirmação de sua existência, o tratamento é mandatório e deve ser realizado precocemente, por causa do risco potencial de ruptura. Esse tratamento pode ser realizado por craniotomia e coagulação da artéria meníngea média, ou por via endovascular com oclusão do aneurisma. Apresentamos neste relato o caso de paciente vítima de traumatismo craniano atendido em nosso serviço. Os exames de imagem iniciais mostravam fratura temporal, associada à contusão hemorrágica adjacente. O paciente foi submetido à angiografia cerebral, sendo diagnosticado um pseudoaneurisma na artéria meníngea média. Ele foi submetido a procedimento endovascular para embolização do aneurisma, tendo evoluído satisfatoriamente.

show abstract

Intracerebral Hemorrhage Caused by Rupture of A Traumatic Pseudoaneurysm of The Middle Meningeal Artery

Kim,

Kim

2023

Preprint

View full text Add to dashboard Cite

Hematoma caused by rupture of a pseudoaneurysm in the middle meningeal artery (MMA) after trauma usually present with epidural hematoma. Intracerebral hemorrhage (ICH) is extremely rare. We reviewed ICH due to rupture of MMA pseudoaneurysm. We found that in cases of acute ICH, a pseudoaneurysm was attached to the outer surface of the dura mater and associated with dura tear. In patients with acute ICH, intraoperative rupture of pseudoaneurysm developed just after bone flap removal. In cases of delayed ICH, pseudoaneurysms adhered to the inner surface of the dura mater. In patients with delayed ICH, intraoperative rupture of pseudoaneurysm developed during dura opening and hematoma removal. In situations of dura tear after trauma, rupture of pseudoaneurysms might lead to ICH via a dura tear. Pseudoaneurysms that develop in the MMA after trauma may exert pressure on and result in the thinning of the dura mater. In this case, pseudoaneurysms will adhere to the inner surface of the dura mater after several days or weeks. ICH might develop through both acute and delayed mechanisms following development of pseudoaneurysms in the MMA. Clinicians should pay attention to the timing of such ruptures during operations for both acute and delayed ICH.

show abstract

Incidental traumatic pseudoaneurysm of the middle meningeal artery- case report and literature review.

Cited by 6 publications

References 9 publications

Endovascular management of acute epidural hematomas: clinical experience with 80 cases

Endovascular management of acute epidural hematomas: clinical experience with 80 cases

Pseudoaneurisma traumático da artéria meníngea média tratado por via endovascular

Intracerebral Hemorrhage Caused by Rupture of A Traumatic Pseudoaneurysm of The Middle Meningeal Artery

Contact Info

Product

Resources

About