N-butyl cyanoacrylate embolization of a traumatic pseudoaneurysm and arteriovenous fistula of the middle meningeal artery

We report a case of combined traumatic pseudoaneurysm and arteriovenous fistula of the middle meningeal artery, which presented clinically 1 year after initial head trauma. A 39-year-old male presented with seizure activity after a closed head injury from a fall. He was hospitalized for multiple int...

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Bibliographic Details
Main Authors: Joshua A. Cuoco, DO, MS, Evin L. Guilliams, DO, Brendan J. Klein, DO, Giovanni R. Malaty, BS, Mark R. Witcher, MD, PhD, John J. Entwistle, DO
Format: Article
Language:English
Published: Elsevier 2020-04-01
Series:Radiology Case Reports
Online Access:http://www.sciencedirect.com/science/article/pii/S1930043319303905
Description
Summary:We report a case of combined traumatic pseudoaneurysm and arteriovenous fistula of the middle meningeal artery, which presented clinically 1 year after initial head trauma. A 39-year-old male presented with seizure activity after a closed head injury from a fall. He was hospitalized for multiple intraparenchymal hemorrhages and ultimately discharged 2 weeks later without neurologic deficits. One year later, he presented with a new right anterior temporal intraparenchymal hemorrhage after a syncopal event. Selective angiography of the right external carotid artery demonstrated a chronic appearing traumatic laceration of the proximal middle meningeal artery with a 6 × 10 mm pseudoaneurysm and a single fistula with venous varix draining into the lateral pterygoid veins. The pseudoaneurysm and arteriovenous fistula were successfully embolized with n-butyl cyanoacrylate. Keywords: Middle meningeal artery, Pseudoaneurysm, Arteriovenous fistula, n-butyl cyanoacrylate, Traumatic aneurysm, Neuroradiology
ISSN:1930-0433