Coil Embolization of a Ruptured Traumatic Pseudoaneurysm of the Middle Meningeal Artery: A Case Report
Abstract
Traumatic pseudoaneurysms of the middle meningeal artery (MMA) are rare and have a poor prognosis due to their high risk of rupture. This study presents a case of a 53-year-old man who experienced rupture of an MMA pseudoaneurysm 10 days after craniotomy for an acute subdural hematoma caused by a blunt head injury. He also had an accompanying temporal bone fracture extending to the skull base. Initial imaging showed no evidence of cerebrovascular injury. The rupture resulted in a temporal hemorrhage with intraventricular extension that caused acute hydrocephalus. Digital subtraction angiography showed that the pseudoaneurysm was located just below the right temporal bone fracture. Coil embolization of the aneurysm was performed and complete occlusion was achieved. His hydrocephalus was addressed with placement of an external ventricular drain, which was later converted to a ventriculoperitoneal shunt. There was no rebleeding and he was transferred to a convalescent hospital. Traumatic MMA pseudoaneurysms usually develop several days after injury and are thus not present on imaging immediately after injury. Aggressive treatment is warranted due to their poor prognosis.
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Evidence Hub reads this as a case report, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
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