Traumatic Middle Meningeal Artery Pseudoaneurysms Presenting with Intractable Epistaxis: A Rare Case Report and Review of Literature

Jun Lu,Jianjun Gu,Zehao Liu,Xiaolin Wang,Shiming Zhang,Guangzhong Gao

doi:10.4236/crcm.2015.41007

Abstract

Middle meningeal artery (MMA) pseudoaneurysms are very rare and are most often traumatic. They may present as an epidural or intraparenchymal hematoma. This study reports a rare case in which a patient suffered from intractable epistaxis because of a pseudoaneurysm in middle meningeal artery and skull base fracture after craniocerebra trauma. Pseudoaneurysm and the feeding artery were embolized by using Onyx-18 liquid embolic system. Complete cessation of bleeding was achieved in this case immediately after the endovascular therapies. In this study, clinical manifestation, diagnostic imaging and endovascular treatment are described. Formation mechanisms and the treatment of traumatic pseudoaneurysm of middle meningeal artery are discussed.

Highlights

Pseudoaneurysms can arise from the branches of the ECA as well as from the ICA system
How to cite this paper: Gu, J.J., Lu, J., Wang, X.L., Liu, Z.H., Gao, G.Z. and Zhang, S.M. (2015) Traumatic Middle Meningeal Artery Pseudoaneurysms Presenting with Intractable Epistaxis: A Rare Case Report and Review of Literature
Zhang et al reported that the majority of traumatic pseudoaneurysms of the ICA responsible for massive epistaxes are based on the cavernous segment and the pseudoaneurysms originated from the internal maxillary artery are responsible for some epistaxes [2]

Summary

Introduction

Pseudoaneurysms can arise from the branches of the ECA as well as from the ICA system. Middle meningeal artery (MMA) pseudoaneurysms are very rare and are most often traumatic. They may present as an epidural or intraparenchymal hematoma [1]. (2015) Traumatic Middle Meningeal Artery Pseudoaneurysms Presenting with Intractable Epistaxis: A Rare Case Report and Review of Literature. Recent studies found that traumatic pseudoaneurysms causes intractable epistaxis. Zhang et al reported that the majority of traumatic pseudoaneurysms of the ICA responsible for massive epistaxes are based on the cavernous segment and the pseudoaneurysms originated from the internal maxillary artery are responsible for some epistaxes [2]. Li et al reported a case of traumatic pseudoaneurysm of the basilar artery presenting with fatal epistaxis [3]. This is the first report of a traumatic pseudoaneurysm of the MMA presenting with epistaxis

Case Report

Discussion

Findings

Conclusion