Life-Threatening Hemorrhage From a Traumatic Aneurysm of the Posterior Meningeal Artery: Treatment with Coil Embolization

Introduction

Traumatic aneurysms of the meningeal arteries are usually associated with blunt trauma [9] [13] [17]. They often manifest as false aneurysms or pseudoaneurysms resulting from incomplete disruption of the vessel wall [3]. While pseudoaneurysms of the middle meningeal artery have been reported occasionally [2] [3] [6] [10] [16] [25] [27], pseudoaneurysms of the posterior meningeal artery are exceedingly rare [8] [22] [26]. Hemorrhage secondary to rupture of a traumatic meningeal artery aneurysm is a serious event associated with high morbidity [1] [2] [3] [5] [6] [7]. There is very limited data on appropriate treatment strategies. Here we present the first case, in which a traumatic pseudoaneurysm was treated using a bioactive coil.

References

• 1 Albert FK, Oldenkott P, Sigmund E. Subarachnoid hemorrhage and intracerebral hematoma in injury of the middle meningeal artery.  Zentralbl Neurochir. 1989;  50 153-156
• 2 Aoki N, Sakai T, Kaneko M. Traumatic aneurysm of the middle meningeal artery presenting as delayed onset of acute subdural hematoma.  Surg Neurol. 1992;  37 59-62
• 3 Bruneau M, Gustin T, Zekhnini K. et al . Traumatic false aneurysm of the middle meningeal artery causing an intracerebral hemorrhage: case report and literature review.  Surg Neurol. 2002;  57 174-178
• 4 Chappell ET, Moure FC, Good MC. Comparison of computed tomographic angiography with digital subtraction angiography in the diagnosis of cerebral aneurysms: a meta analysis.  Neurosurgery. 2003;  52 624-631
• 5 Chedid MK, Vender JR, Harrison SJ. et al . Delayed appearance of a traumatic intracranial aneurysm.  J Neurosurg. 2001;  94 637-641
• 6 Crooks DA. Pathogenesis and biomechanics of traumatic intracranial haemorrhages.  Virchows Arch A Pathol Anat Histopathol. 1991;  418 479-483
• 7 Higazi I, El–Banhawy A, El–Nady F. Importance of angiography in identifying false aneurysm of the middle meningeal artery as a cause of extradural hematoma: case report.  J Neurosurg. 1969;  30 172-176
• 8 Higurashi M, Takemoto Y, Osano S. et al . A case of post-traumatic pseudoaneurysm on the posterior meningeal artery.  No Shinkei Geka. 2002;  30 1111-1115
• 9 Laun A. Traumatic aneurysms. In: Pia HW, Langmain C, Zierski J, (eds) Cerebral Aneurysms: Advances in Diagnosis and Therapy. Berlin: Springer-Verlag; 1979: 364-374
• 10 Lesley WS, Thomas MR, Abdulrauf SI. N-butylcyanoacrylate embolization of a middle meningeal artery aneurysm in a patient with neurofibromatosis type 2.  Am J Neuroradiol. 2004;  25 1414-1416
• 11 Li Q, Lv F, Li Y. et al . Evaluation of 64-section CT angiography for detection and treatment planning of intracranial aneurysms by using DSA and surgical findings.  Radiology. 2009;  252 808-815
• 12 McKinney AM, Palmer CS, Truwit CL. et al . Detection of aneurysms by 64-section multidetector CT angiography in patients acutely suspected of having an intracranial aneurysm and comparison with digital subtraction and 3D rotational angiography.  Am J Neuroradiol. 2008;  29 594-602
• 13 Mendel RC, Carter LP. Traumatic intracranial aneurysms. In: Carter LP, Spetzler RF, Hamilton MG (eds) Neurovascular Surgery. New York: McGraw-Hill; 1979: 1301-1312
• 14 Moron F, Benndorf G, Akpek S. et al . Spontaneous thrombosis of a traumatic posterior cerebral artery aneurysm in a child.  Am J Neuroradiol. 2005;  26 58-60
• 15 Ogilvy CS, Hoh BL, Singer RJ. et al . Clinical and radiographic outcome in the management of posterior circulation aneurysms by use of direct surgical or endovascular techniques.  Neurosurgery. 2002;  51 14-21
• 16 O`Neill OR, Barnwell SL, Silver DJ. Middle meningeal artery aneurysm associated with meningeoma: case report.  Neurosurgery. 1995;  36 396-398
• 17 Parkinson D, West M. Traumatic intracranial aneurysms.  J Neurosurg. 1980;  52 11
• 18 Raimondi AJ, Yashon D, Reyes C. et al . Intracranial false aneurysms.  Neurochirurgia. 1968;  11 219-233
• 19 Romijn M, Gratama van Andel HAF, van Walderveen MA. et al . Diagnostic accuracy of CT angiography with matched mask bone elimination for detection of intracranial aneurysms: comparison with digital subtraction angiography and 3D rotational angiography.  Am J Neuroradiol. 2008;  29 134-139
• 20 Roski RA, Owen M, White RJ. et al . Middle meningeal artery trauma.  Surg Neurol. 1982;  l17 200-203
• 21 Rossitti S. Endovascular coiling of intracranial aneurysms. Using bioactive coils: a single center study.  Acta Radiol. 2007;  48 565-576
• 22 Ryfkogel HAL. Rupture of the posterior meningeal artery without fracture at the point of injury.  Cal State J Medicine. 1907;  5 180-181
• 23 Shukla V, Hayman LA, Ly C. et al . Adult cranial dura: intrinsic vessels.  J Comp Assist Tomogr. 2002;  26 1069-1074
• 24 Stracke CP, Krings T, Möller-Hartmann W. et al . Severe inflammatory reaction of the optic system after endovascular treatment of a supraophthalmic aneurysm with bioactive coils.  AJNR Am J Neuroradiol. 2007;  28 1401-1402
• 25 Srinivasan A, Lesiuk H, Goyal M. Spontaneous resolution of posttraumatic middle meningeal artery pseudoaneurysm.  Am J Neuroradiol. 2006;  27 882-883
• 26 Toro VE, Fravel JF, Weidmann TA. et al . Posttraumatic pseudoaneurysm of the posterior meningeal artery associated with intraventricular hemorrhage.  Am J Neuroradiol. 1993;  14 264-266
• 27 Tsutsumi M, Kazekawa K, Tanaka A. et al . Traumatic middle meningeal artery pseudoaneurysm and subsequent fistula formation with the cavernous sinus.  Surg Neurol. 2002;  58 325-328
• 28 Turk AS, Luty CM, Carr-Brendel V. et al . Angiographic and histological comparison of canine bifurcation aneurysms treated with first generation matrix and standard GDC coils.  Neuroradiology. 2008;  50 57-65
• 29 Yuki I, Lee D, Murayama Y. et al . Thrombus organization and healing in an experimental aneurysm model. Part II. The effect of various types of bioactive bioabsorbable polymeric coils.  J Neurosurg. 2007;  107 109-120

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