Abstract
A 48-year-old male patient presented with a single generalized epileptic seizure and a history of migraine with a left superior quadrantanopia. Diagnostic imaging revealed a large brain arteriovenous malformation (AVM) of the right occipital lobe. A treatment concept of preoperative embolization followed by microsurgical excision was offered to and accepted by the patient. During the first endovascular treatment session, an incidental aneurysm of the right middle meningeal artery (MMA) was found. The right MMA was supplying the pial AVM. Both the right MMA and the aneurysm were occluded by the injection of n-butyl cyanoacrylate diluted with Lipiodol. After a total of 16 embolization sessions, the large AVM was sufficiently devascularized to allow for a microsurgical excision of the AVM, 27 months after the first embolization. Both the endovascular and the microsurgical treatment were carried out without any issues and the complete interruption of the AV-shunt was confirmed by angiography. Occurrence and management of non-traumatic MMA aneurysms is the main topic of this chapter.
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References
Akyuz M, Tuncer R. Multiple middle meningeal artery aneurysms associated with fistulous galenic arteriovenous malformation: a case report. Turk Neurosurg. 2010;20(4):544–6. https://doi.org/10.5137/1019-5149.JTN.1747-09.2.
Berk ME. Aneurysm of the middle meningeal artery. Br J Radiol. 1961;34:667–8.
Bollati A, Galli G, Gandolfini M, Orlandini A, Gualandi GF. True aneurysm of the middle meningeal artery. Case report. J Neurosurg Sci. 1980;24(2):89–92.
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(5):347–50. https://doi.org/10.1016/j.neurad.2017.06.007.
Holland HW, Thomson JL. Aneurysm of the middle meningeal artery. Clin Radiol. 1965;16(4):334–8.
Kähärä VJ. Middle meningeal artery aneurysm. Case illustration. J Neurosurg. 1999;91(3):518.
Kobata H, Tanaka H, Tada Y, Nishihara K, Fujiwara A, Kuroiwa T. Intracerebral hematoma due to ruptured nontraumatic middle meningeal artery aneurysm – case report. Neurol Med Chir (Tokyo). 2001;41(12):611–4.
Koebbe CJ, Horowitz MB. A rare case of a ruptured middle meningeal aneurysm causing intracerebral hematoma in a patient with moyamoya disease. AJNR Am J Neuroradiol. 2004;25(4):574–6.
Korosue K, Kondoh T, Ishikawa Y, Nagao T, Tamaki N, Matsumoto S. Acute subdural hematoma associated with nontraumatic middle meningeal artery aneurysm: case report. Neurosurgery. 1988;22(2):411–3.
Kpelao E, Beketi KA, Ahanogbe KMH, Moumouni AK, Doleagbenou AK, Egu K, Ntimon B, Tchaou M, Egbohou P. Middle meningeal artery aneurysm: case report. Surg Neurol Int. 2017;8:172. https://doi.org/10.4103/sni.sni_159_17.
Lesley WS, Thomas MR, Abdulrauf SI. N-butylcyanoacrylate embolization of a middle meningeal artery aneurysm in a patient with neurofibromatosis type 2. AJNR Am J Neuroradiol. 2004;25(8):1414–6.
Maekawa H, Tanaka M, Hadeishi H. Middle meningeal artery aneurysm associated with meningioma. Acta Neurochir. 2009;151(9):1167–8. https://doi.org/10.1007/s00701-009-0263-z.
Ohta H, Tanazawa T, Osuka K, Ito Y, Fukatsu T. True aneurysms of the middle meningeal artery associated with cavernous hemangioma of the skull – case report. Neurol Med Chir (Tokyo). 1991;31(4):203–5.
Sandin JA 3rd, Salamat MS, Baskaya M, Dempsey RJ. Intracerebral hemorrhage caused by the rupture of a nontraumatic middle meningeal artery aneurysm. Case report and review of the literature. J Neurosurg. 1999;90(5):951–4.
Zingesser LH, Schechter MM, Rayport M. Truths and untruths concerning the angiographic findings in extracerebal haematomas. Br J Radiol. 1965;38(455):835–47.
Zubkov YN, Matsko DE, Pak VA. Saccular aneurysms of meningeal artery: case report. Neurosurgery. 1998;42(3):664–6.
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Bhogal, P., Aguilar Pérez, M., Alfter, M., Ganslandt, O., Henkes, H. (2018). Middle Meningeal Artery Aneurysm: Non-traumatic Incidental Aneurysm of a Middle Meningeal Artery Supplying a Pial Arteriovenous Malformation; Endovascular Occlusion of the Aneurysm Using nBCA During the Preoperative Embolization of the AVM. In: Henkes, H., Lylyk, P., Ganslandt, O. (eds) The Aneurysm Casebook. Springer, Cham. https://doi.org/10.1007/978-3-319-70267-4_20-1
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DOI: https://doi.org/10.1007/978-3-319-70267-4_20-1
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