Traumatic middle meningeal artery aneurysm: a case report

Area of Science:

• Neurosurgery
• Vascular Neurology
• Radiology

Background:

• Traumatic intracranial aneurysms are uncommon, accounting for approximately 1% of all intracranial aneurysms.
• The middle meningeal artery (MMA), crucial for cranial dura mater supply, is vulnerable to injury due to its anatomical position.
• This article presents a rare instance of a giant post-traumatic MMA pseudoaneurysm.

Observation:

• A 45-year-old male with a history of craniectomy presented with non-specific headaches and a normal neurological exam.
• A follow-up CT scan revealed a hyperdense mass in the right temporal fossa.
• Digital subtraction angiography confirmed a traumatic MMA aneurysm.

Findings:

• The patient underwent successful treatment via preoperative embolization and surgical resection.
• Traumatic MMA aneurysms can present atypically, sometimes discovered incidentally.
• Pseudoaneurysms are rare but significant complications of MMA trauma, often with delayed presentation.

Implications:

• Clinicians should consider traumatic MMA pseudoaneurysms in patients with a history of traumatic brain injury and extra-axial temporal fossa masses.
• Early diagnosis and appropriate management, including embolization and resection, are crucial for favorable outcomes.
• This case highlights the importance of considering rare vascular complications in the context of head trauma.