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Ramirez Velandia F, Young M, Ogilvy CS. Spontaneous Middle Meningeal Artery Aneurysms: A Case Report and Review of the Literature. Cureus 2023; 15:e49407. [PMID: 38149141 PMCID: PMC10749994 DOI: 10.7759/cureus.49407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 11/25/2023] [Indexed: 12/28/2023] Open
Abstract
Most reported aneurysms concerning the middle meningeal artery (MMA) are pseudoaneurysms; however, there have been rare reports of non-traumatic MMA aneurysms in the literature. In this paper, we present the case of a 70-year-old female with a true 5-mm aneurysm in the anterior division of the left MMA that was causing erosion through the left temporal bone and was successfully treated with coil embolization. We also present a comprehensive literature review of non-traumatic MMA aneurysms reported since 1930. These aneurysms are associated with conditions such as hypertension, Paget's disease, and intracranial meningiomas and result from flow dynamics disturbances. Treatment involves both endovascular treatment and open surgery, while rupture, especially in the elderly, results in high disability, underscoring the importance of timely intervention upon identification.
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Affiliation(s)
| | - Michael Young
- Neurosurgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, USA
| | - Christopher S Ogilvy
- Neurosurgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, USA
- Neurosurgery, Beth Israel Deaconess Medical Center (BIDMC) Brain Aneurysm Institute, Boston, USA
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Miyamoto S, Hosoo H, Ishikawa E, Matsumaru Y. Spontaneous Middle Meningeal Arteriovenous Fistula Caused by Aneurysm Rupture: A Case Report. NMC Case Rep J 2023; 10:81-85. [PMID: 37065874 PMCID: PMC10101702 DOI: 10.2176/jns-nmc.2022-0376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 01/11/2023] [Indexed: 04/18/2023] Open
Abstract
Middle meningeal arteriovenous fistula (MMAVF) is a shunt between the middle meningeal artery and the vein surrounding the artery. We report an extremely rare case of spontaneous MMAVF; then, we evaluated the effectiveness of trans-arterial embolization for spontaneous MMAVF and the possible cause of spontaneous MMAVF. A 42-year-old man with tinnitus, a left temporal headache, and pain surrounding the left mandibular joint was diagnosed with MMAVF on digital subtraction angiography. Trans-arterial embolization with detachable coils was conducted, which resulted in a fistula closure and symptoms' diminishment. The cause of MMAVF was thought to be the rupture of the middle meningeal artery aneurysm. A middle meningeal artery aneurysm can be a cause of spontaneous MMAVF, and trans-arterial embolization might be an optimal treatment.
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Affiliation(s)
- Satoshi Miyamoto
- Division of Stroke Prevention and Treatment, Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
- Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Hisayuki Hosoo
- Division of Stroke Prevention and Treatment, Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
- Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Eiichi Ishikawa
- Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Yuji Matsumaru
- Division of Stroke Prevention and Treatment, Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
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O'Neill BE, Wozny T, Uluc K, Liu JJ. Acute nontraumatic subdural hematoma from ruptured accessory meningeal artery pseudoaneurysm. Surg Neurol Int 2021; 12:186. [PMID: 34084614 PMCID: PMC8168677 DOI: 10.25259/sni_50_2021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 04/01/2021] [Indexed: 11/23/2022] Open
Abstract
Background: Cerebral angiography including internal and external carotid artery injections is crucial in young patients with a spontaneous subdural hematoma. Case Description: We present the first reported case of an accessory meningeal artery aneurysm in a 46-year-old male with a history of hypertension that led to a spontaneous nontraumatic acute subdural hematoma. A PubMed review of the literature was performed using a keyword search to identify cases examining nontraumatic spontaneous intracranial hematomas related to meningeal artery aneurysms. The literature review summarizes all published reports of middle meningeal artery aneurysms resulting in nontraumatic acute intracranial bleeds. The patient underwent successful coiling of the accessory meningeal artery. Conclusion: We propose endovascular treatment for accessory meningeal artery aneurysms and emphasize the utility of angiography of internal and external carotid arteries in a patient with an unexplained intracranial hematoma.
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Affiliation(s)
- Brannan E O'Neill
- Department of Neurosurgery, Oregon Health and Science University, Portland, Oregon, United States
| | - Thomas Wozny
- Department of Neurosurgery, University of California at San Francisco, San Francisco, California, United States
| | - Kutluay Uluc
- Department of Neurosurgery, Oregon Health and Science University, Portland, Oregon, United States
| | - Jesse J Liu
- Department of Neurosurgery, Oregon Health and Science University, Portland, Oregon, United States
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Vilalta J, Martínez-Ricarte F, Martínez-Sáez EA, Gándara D, Arikan F. Non traumatic giant aneurysm of middle meningeal artery. Case report and review of the literature. Neurocirugia (Astur) 2018; 29:250-254. [PMID: 29292165 DOI: 10.1016/j.neucir.2017.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Accepted: 11/19/2017] [Indexed: 10/18/2022]
Abstract
A case of a non-traumatic giant aneurysm of the middle meningeal artery is presented in a 59-year-old patient with a history of liver transplantation, liver cirrhosis and hepatocarcinoma, chronic renal disease, hypertension and chronic bronchitis who presented with tonic-clonic seizures. CT and MRI showed a lesion suggestive of metastasis without ruling out a glial type tumor. He was operated through a left FT craniotomy. During the surgery there was an arterial hemorrhage. The histological sample oriented toward an aneurysmal origin that was confirmed with ARM and angiography. A second intervention allowed the removal of a giant middle meningeal aneurysm partially thrombosed. Aneurysms of the middle meningeal artery are rare and generally present a traumatic history. No case of giant aneurysm has been found in the medical literature.
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Affiliation(s)
- Jordi Vilalta
- Servicio de Neurocirugía, Hospital Vall d'Hebron, Barcelona, España.
| | | | | | - Darío Gándara
- Servicio de Neurocirugía, Hospital Vall d'Hebron, Barcelona, España
| | - Fuat Arikan
- Servicio de Neurocirugía, Hospital Vall d'Hebron, Barcelona, España
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Hedjoudje A, Curado A, Tonnelet D, Gerardin E, Clavier E, Papagiannaki C. Middle meningeal artery aneurysm associated with diffuse calvarial metastases: A case report and review of the literature. J Neuroradiol 2017; 44:347-350. [PMID: 28801141 DOI: 10.1016/j.neurad.2017.06.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2017] [Revised: 06/21/2017] [Accepted: 06/30/2017] [Indexed: 11/25/2022]
Affiliation(s)
- Abderrahmane Hedjoudje
- Department of Radiology, University Hospital of Rouen, CHU de Rouen, 31, rue de Germont, 76000 Rouen, France.
| | - Adelya Curado
- Department of Vascular and Interventional Radiology, University Hospital of Rouen, Rouen, France
| | - David Tonnelet
- Department of Nuclear Medicine, Henri Becquerel Cancer Center, Rouen, France
| | - Emmanuel Gerardin
- Department of Radiology, University Hospital of Rouen, CHU de Rouen, 31, rue de Germont, 76000 Rouen, France
| | - Erick Clavier
- Department of Vascular and Interventional Radiology, University Hospital of Rouen, Rouen, France
| | - Chrysanthi Papagiannaki
- Department of Vascular and Interventional Radiology, University Hospital of Rouen, Rouen, France
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Settecase F, Nicholson AD, Amans MR, Higashida RT, Halbach VV, Cooke DL, Dowd CF, Hetts SW. Onyx embolization of an intraosseous pseudoaneurysm of the middle meningeal artery in a patient with meningiomatosis, McCune-Albright syndrome, and gray platelet syndrome. J Neurosurg Pediatr 2016; 17:324-9. [PMID: 26588455 DOI: 10.3171/2015.9.peds15267] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
A 13-year-old boy with meningiomatosis, McCune-Albright syndrome, and gray platelet syndrome presented with an enlarging "lump" on his right forehead. A head CT scan revealed a polyostotic fibrous dysplasia involving the entire skull. A 3.4-cm right frontal osseous cavity and an overlying right forehead subcutaneous soft-tissue mass were seen, measuring 5.2 cm in diameter and 1.6 cm thick. Ultrasound of the cavity and overlying mass showed swirling of blood and an arterialized waveform. MRI revealed an en plaque meningioma underlying the cavity. An intraosseous pseudoaneurysm fed by 3 distal anterior division branches of the right middle meningeal artery (MMA) with contrast extravasation was found on angiography. Two MMA feeders were embolized with Onyx, with anterograde filling of the intraosseous cavity with Onyx. A small pocket of residual intracavity contrast filling postembolization from a smaller third MMA feeder eventually thrombosed and the forehead lump regressed.
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Affiliation(s)
- Fabio Settecase
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California
| | - Andrew D Nicholson
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California
| | - Matthew R Amans
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California
| | - Randall T Higashida
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California
| | - Van V Halbach
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California
| | - Daniel L Cooke
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California
| | - Christopher F Dowd
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California
| | - Steven W Hetts
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California
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Yu J, Guo Y, Xu B, Xu K. Clinical importance of the middle meningeal artery: A review of the literature. Int J Med Sci 2016; 13:790-799. [PMID: 27766029 PMCID: PMC5069415 DOI: 10.7150/ijms.16489] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Accepted: 08/22/2016] [Indexed: 12/15/2022] Open
Abstract
The middle meningeal artery (MMA) is a very important artery in neurosurgery. Many diseases, including dural arteriovenous fistula (DAVF), pseudoaneurysm, true aneurysm, traumatic arteriovenous fistula (AVF), moyamoya disease (MMD), recurrent chronic subdural hematoma (CSDH), migraine and meningioma, can involve the MMA. In these diseases, the lesions occur in either the MMA itself and treatment is necessary, or the MMA is used as the pathway to treat the lesions; therefore, the MMA is very important to the development and treatment of a variety of neurosurgical diseases. However, no systematic review describing the importance of MMA has been published. In this study, we used the PUBMED database to perform a review of the literature on the MMA to increase our understanding of its role in neurosurgery. After performing this review, we found that the MMA was commonly used to access DAVFs and meningiomas. Pseudoaneurysms and true aneurysms in the MMA can be effectively treated via endovascular or surgical removal. In MMD, the MMA plays a very important role in the development of collateral circulation and indirect revascularization. For recurrent CDSHs, after burr hole irrigation and drainage have failed, MMA embolization may be attempted. The MMA can also contribute to the occurrence and treatment of migraines. Because the ophthalmic artery can ectopically originate from the MMA, caution must be taken to avoid causing damage to the MMA during operations.
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Affiliation(s)
- Jinlu Yu
- Department of Neurosurgery, First Hospital of Jilin University, Changchun, China
| | - Yunbao Guo
- Department of Neurosurgery, First Hospital of Jilin University, Changchun, China
| | - Baofeng Xu
- Department of Neurosurgery, First Hospital of Jilin University, Changchun, China
| | - Kan Xu
- Department of Neurosurgery, First Hospital of Jilin University, Changchun, China
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Maekawa H, Tanaka M, Hadeishi H. Middle meningeal artery aneurysm associated with meningioma. Acta Neurochir (Wien) 2009; 151:1167-8. [PMID: 19319475 DOI: 10.1007/s00701-009-0263-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2009] [Accepted: 03/01/2009] [Indexed: 10/21/2022]
Abstract
Middle meningeal artery aneurysm associated with meningioma is extremely rare, and only two cases have previously been reported. In our case, a 72-year-old woman with convexity meningioma underwent preoperative cerebral angiography, which revealed a flow-related aneurysm on the middle meningeal artery. Embolization of the aneurysm was performed with N-butycyanoacrylate glue, and complete obliteration was confirmed under craniotomy. In order to eliminate the risk of preoperative rupture resulting in intracranial hemorrhage, endovascular embolization with liquid glue is safe and effective for this kind of aneurysm.
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Akyol C, Turkoglu E, Kazancı B, Seckin H, Kertmen H, Bavbek M. Intraparenchymal haematoma related to true middle meningeal artery aneurysm: a case report. BMJ Case Rep 2009; 2009:bcr03.2009.1711. [PMID: 21886663 DOI: 10.1136/bcr.03.2009.1711] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Non-traumatic middle meningeal artery aneurysm and rupture resulting in intracranial haemorrhage is rare. In the present case, a 73-year-old man was admitted to hospital with a history of a minor head trauma. A CT scan of the head revealed a 2×2 cm intraparenchymal haematoma without significant mass effect in the left temporal lobe. The cerebral angiogram revealed a middle meningeal artery aneurysm. Intracerebral haematoma due to extracranial aneurysm is extremely rare, but should be considered when the history is suspicious and cranial CT is non-contributory.
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Affiliation(s)
- Cetin Akyol
- Ministry of Health Diskapi Yildirim Beyazit Research and Educational Hospital Neurosurgery Clinic, SB Diskapi Yildirim Beyazit Egitim ve Arastirma Hastanesi, Altindag, Ankara, 06110, Turkey
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Chen W, Wang J, Xing W, Xu Q, Qiu J, Huang Q, Sun Y, Yu S, Peng Y. Accuracy of 16-row multislice computerized tomography angiography for assessment of intracranial aneurysms. ACTA ACUST UNITED AC 2009; 71:32-42. [PMID: 18930311 DOI: 10.1016/j.surneu.2007.08.005] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2006] [Accepted: 08/01/2007] [Indexed: 11/30/2022]
Affiliation(s)
- Wenhua Chen
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, P.R. China.
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Biondi A. Intracranial aneurysms associated with other lesions, disorders or anatomic variations. Neuroimaging Clin N Am 2006; 16:467-82, viii. [PMID: 16935711 DOI: 10.1016/j.nic.2006.05.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Intracranial aneurysms (IAs) can be related to or associated with some vascular anatomic variations, lesions, diseases, or systemic disorders in which a causative or predisposing factor(s) in aneurysm formation can be identified. This article includes flow-related, infectious, traumatic iatrogenic, and neoplastic aneurysms and aneurysms related to systemic disorders and drug abuse. In some conditions, IAs associated with other disorders are true aneurysms. Most of them, however, are false aneurysms. Characteristics and management of these unusual aneurysms are discussed.
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Affiliation(s)
- Alessandra Biondi
- Neurovascular Interventional Section, Department of Neuroradiology, Pitié-Salpêtrière Hospital, Paris VI University School of Medicine, 47-83 Boulevard de l'Hôpital, 75651 Paris, France.
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Traumatic pseudoaneurysm of the middle meningeal artery and cerebral intraparenchymal hematoma: case report. SURGICAL NEUROLOGY 2006; 66 Suppl 3:S29-31. [PMID: 17081850 DOI: 10.1016/j.surneu.2006.08.048] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2006] [Accepted: 08/24/2006] [Indexed: 11/19/2022]
Abstract
BACKGROUND Pseudoaneuryms of the MMA are rare lesions, accounting for less than 1% of all intracranial aneurysms. CASE DESCRIPTION We report a case of a spontaneous intracerebral hematoma that DSA revealed as ispilateral traumatic PMMA. The lesion was managed through an endovascular approach, and definitive embolization of pseudoaneurysm and parent vessel with histoacryl injection was carried out. Recovery and follow-up were uneventful. We discuss the management of those lesions, emphasizing the current neuroendovascular tools and techniques. CONCLUSION Pseudoaneurysm of the MMA is uncommon but has a potential aggressive natural history. As it can occur with different patterns of intracranial hemorrhage, the external carotid arteries have to be included in hemorrhagic investigational DSA. Once diagnosed, it must be treated. The minimally invasive endovascular approach and definitive embolization of pseudoaneurysm and parent vessel with histoacryl injection are safe and effective.
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