背景:颅内假性动脉瘤是一种罕见的实体,文献中描述的案例很少,主要与创伤性脑损伤史有关。创伤性动脉瘤占所有颅内动脉瘤的<1%。特别是,脑膜中动脉(MMA)动脉瘤并不常见,通常由颞部颅骨骨折引起。文献报道了约40例创伤性MMA动脉瘤,只有28个非创伤性动脉瘤被报道,通常与高流量条件有关。这些动脉瘤的行为在很大程度上是未知的:自发消退和动脉瘤生长,导致随后的破裂,已被报道。手术和血管内治疗对MMA动脉瘤是可行的;然而,标准治疗没有定义。
方法:我们报告了一例右MMA的创伤性假性动脉瘤,并提供了文献综述。
结论:MMA动脉瘤是一种罕见的实体,在创伤性脑损伤或诱发因素的情况下必须考虑。诊断和积极治疗是强制性的,防止它们破裂的毁灭性后果。血管内和外科技术是明确的和可用的,即使他们中的任何一个都没有表现出优越性。
BACKGROUND: Intracranial pseudoaneurysm is a rare entity, with few cases described in the literature, and is mostly associated with a history of traumatic brain injury. Traumatic aneurysms comprise <1% of all intracranial aneurysms. In particular, middle meningeal artery (MMA) aneurysms are uncommon and usually caused by a skull fracture in the temporal region. About 40 traumatic MMA aneurysms are reported in the literature, and only 28 nontraumatic aneurysms are reported, usually related to high-flow conditions. The behavior of these aneurysms is largely unknown: both spontaneous resolution and aneurysm growth, leading to subsequent rupture, have been reported. Surgical and endovascular management are feasible for MMA aneurysms; however, the criterion standard treatment is not defined.
METHODS: We report the
case of a traumatic pseudoaneurysm of the right MMA treated with an endovascular approach and provide a review of the literature.
CONCLUSIONS: Aneurysms of the MMA are a rare entity that must be taken into account in the setting of a traumatic brain injury or predisposing factors. The diagnosis and aggressive treatment are mandatory, preventing the devastating consequences of their rupture. Endovascular and surgical techniques are well defined and available, even though there is not a demonstrated superiority in any of them.