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Coil embolization for post-bypass aneurysm of middle meningeal artery for moyamoya disease – preservation of transdural anastomosis

BACKGROUND: Middle meningeal artery (MMA) pseudoaneurysm following revascularization surgery for moyamoya disease (MMD) is rare. CASE DESCRIPTION: Here, a 29-year-old man presented with an MMA pseudoaneurysm after he underwent revascularization surgery (superficial temporal artery-to-middle cerebral...

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Detalles Bibliográficos
Autores principales: Maruyama, Kunitaka, Kashiwazaki, Daina, Yamamoto, Shusuke, Akioka, Naoki, Hori, Emiko, Kuroda, Satoshi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Scientific Scholar 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10159324/
https://www.ncbi.nlm.nih.gov/pubmed/37151426
http://dx.doi.org/10.25259/SNI_224_2023
Descripción
Sumario:BACKGROUND: Middle meningeal artery (MMA) pseudoaneurysm following revascularization surgery for moyamoya disease (MMD) is rare. CASE DESCRIPTION: Here, a 29-year-old man presented with an MMA pseudoaneurysm after he underwent revascularization surgery (superficial temporal artery-to-middle cerebral artery bypass and encephalo-duro-myoarterio-pericranial synangiosis) for hemorrhagic MMD. At 3 months post-surgery, digital subtraction angiography showed a pseudoaneurysm in the right MMA. Transdural anastomosis to the parietal and occipital lobes was opacified at the distal MMA of the pseudoaneurysm. Intra-aneurysmal coil embolization was performed for preservation of transdural anastomosis. The postoperative course was uneventful. At 1 month post-embolization, angiography revealed an entirely occluded pseudoaneurysm. CONCLUSION: An increase in blood flow in the MMA due to bypass surgery may accelerate aneurysm development by increasing the hemodynamic stress. This case suggested that intra-aneurysmal embolization may be a potential treatment.