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Posttraumatic Pseudoaneurysm of the Middle Meningeal Artery:a case report Teruo KIMURA 1,2 , Kazuhiro SAKO 2 , Masao SATOH 1 , Hirofumi NAKAI 1 , Yuukichi YONEMASU 2 , Eriho TAKEUCHI 3 , Hiroshi ISHIKURA 3 1Department of Neurosurgery, Nayoro City Hospital 2Department of Neurosurgery, Asahikawa Medical College 3Department of Clinical Pathology, Hokkaido University School of Medicine Keyword: Head injury , Skull fracture , Acute epidural hematoma , Middle meningeal artery , Pseudoaneurysm pp.1021-1025
Published Date 1995/11/10
DOI https://doi.org/10.11477/mf.1436901116
  • Abstract
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An epidural hematoma associated with posttraumatic pseudoaneurysm of the middle meningeal artery is a very rare clinical entity. Only 31 such cases have been reported in the literature.

A 54-year-old man was admitted with lethargy and right hemiparesis. A skull X-ray film revealed a linear fracture in the left parietal and temporal bone, extend-ing to the base of the skull. A brain CT scan disclosed an acute epidural hematoma over the left cerebral hemisphere, contusional hematoma in the right frontal lobe and thalamus, and subarachnoid hemorrhage in the left Sylvian fissure. During an emergency cra-niotomy a large epidural hematoma was evacuated and external decompression was performed. Angiography, which was performed about one month after the head injury, revealed an aneurysm of the middle meningeal artery. The aneurysm was removed to avoid delayed rupture at the time of cranioplasty. Histological diagno-sis was pseudoaneurysm.

We discussed the pathogenesis of a pseudoaneurysm of the meningeal artery and the necessity to pay atten-tion to the presence of a pseudoaneurysm when an ac-tive bleeding point is not observed during surgery of the epidural hematoma.


Copyright © 1995, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1251 印刷版ISSN 0301-2603 医学書院

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