Acute nontraumatic subdural hematoma from ruptured accessory meningeal artery pseudoaneurysm

Brannan E O'Neill; Thomas Wozny; Kutluay Uluc; Jesse J Liu

doi:10.25259/SNI_50_2021

Acute nontraumatic subdural hematoma from ruptured accessory meningeal artery pseudoaneurysm

Surg Neurol Int. 2021 Apr 26:12:186. doi: 10.25259/SNI_50_2021. eCollection 2021.

Authors

Brannan E O'Neill¹, Thomas Wozny², Kutluay Uluc¹, Jesse J Liu¹

Affiliations

¹ Department of Neurosurgery, Oregon Health and Science University, Portland, Oregon, United States.
² Department of Neurosurgery, University of California at San Francisco, San Francisco, California, United States.

Abstract

Background: Cerebral angiography including internal and external carotid artery injections is crucial in young patients with a spontaneous subdural hematoma.

Case description: We present the first reported case of an accessory meningeal artery aneurysm in a 46-year-old male with a history of hypertension that led to a spontaneous nontraumatic acute subdural hematoma. A PubMed review of the literature was performed using a keyword search to identify cases examining nontraumatic spontaneous intracranial hematomas related to meningeal artery aneurysms. The literature review summarizes all published reports of middle meningeal artery aneurysms resulting in nontraumatic acute intracranial bleeds. The patient underwent successful coiling of the accessory meningeal artery.

Conclusion: We propose endovascular treatment for accessory meningeal artery aneurysms and emphasize the utility of angiography of internal and external carotid arteries in a patient with an unexplained intracranial hematoma.

Keywords: Angiography; Meningeal artery aneurysm; Spontaneous subdural hematoma.

Publication types

Case Reports