Endovascular Management of Ruptured Traumatic Middle Meningeal Artery Pseudo aneurysm and Arteriovenous Fistula

UMohamad Abdalkader, Artem Kal

Abstract

Pseudoaneurysm and arteriovenous fistula are the most common traumatic vascular injuries of the Middle Meningeal Artery (MMA). Although considered as a protection mechanism against epidural hematoma formation, these lesions carry a high risk of secondary rupture leading to delayed intracranial bleeding with high morbidity and mortality. The concomitant presence of both conditions is rarely reported. We report a case of post traumatic pseudoaneurysm and fistula of the MMA complicated by acute rupture and intracranial bleeding successfully treated by endovascular coiling and Onyx® embolization. We provide a literature review on both conditions and their endovascular management.