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Microsurgical Clip Obliteration of Middle Cerebral Aneurysm Using Intraoperative Flow Assessment
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Infected aneurysm of middle meningeal artery causing intracerebral hemorrhage: illustrative case

Mana Suzuki1, Taichi Ishiguro1, Yoshihiro Omura1

  • 1Department of Neurosurgery, Tokyo Women's Medical University Yachiyo Medical Center, Chiba, Japan.

Journal of Neurosurgery. Case Lessons
|June 30, 2025
PubMed
Abstract

Insights

Nontraumatic middle meningeal artery (MMA) aneurysms are rare but can cause fatal intracranial hemorrhage. Prompt diagnosis and treatment are crucial for infected MMA aneurysms, as illustrated by a case linked to periodontal disease.

Area of Science:

  • Neurosurgery
  • Vascular Neurology
  • Infectious Diseases

Background:

  • Middle meningeal artery (MMA) aneurysms are uncommon and often linked to trauma.
  • Nontraumatic MMA aneurysms are exceptionally rare and their rupture can result in severe intracranial hemorrhage.

Purpose of the Study:

  • To present a case of a ruptured, infected nontraumatic MMA aneurysm.
  • To review and characterize previously reported cases of nontraumatic MMA aneurysms.

Main Methods:

  • Case presentation of a patient with a ruptured MMA aneurysm requiring surgical intervention.
  • Systematic literature search and review of 33 published cases of nontraumatic MMA aneurysms.
  • Pathological examination of the resected aneurysm to identify infectious or inflammatory causes.

Main Results:

  • The illustrative case involved a ruptured MMA aneurysm secondary to presumed spread of infection from periodontal disease.
  • Literature review indicated that nontraumatic MMA aneurysms are rare, with few cases attributed to infectious etiologies.
  • The patient underwent successful hematoma evacuation and aneurysm resection.

Conclusions:

  • Ruptured nontraumatic MMA aneurysms, particularly those of infectious origin, pose a significant risk of fatal intracranial hemorrhage.
  • Early diagnosis and prompt surgical intervention are essential for managing these rare but dangerous vascular lesions.
  • Periodontal disease can be a potential, albeit rare, source of infection leading to MMA aneurysm formation and rupture.
Keywords:
aneurysmcase reportintracerebral hemorrhagemiddle meningeal arteryrupture

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