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Journal of Neurosurgical Sciences 2000 Marzo;44(1):39-41

lingua: Inglese

Middle meningeal artery aneurysm associated with meningioma

Lama M. 1, Mottolese C. 2

1 Department of Neurosurgery, Ospedale Loreto Nuovo, Napoli, Italy;
2 Service de Neurochirurgie “B”, Hôpital Neurologique, Lyon, France


The aneu­rysms of ­the mid­dle menin­geal ­artery ­are extreme­ly ­rare. 30 pseu­do­aneur­ysms of ­the mid­dle menin­geal ­artery (­MMA) ­are report­ed in lit­er­a­ture. These ­are post-trau­mat­ic ­lesions dif­fer­ent ­from ­the ­true aneu­rysms ­that ­have a dif­fer­ent ori­gin. In ­fact ­they ­can be asso­ciat­ed ­with arter­i­ov­e­nous mal­for­ma­tions, Paget’s dis­ease ­and ­tumors; nev­er­the­less in ­some cas­es ­the gen­e­sis ­remains ­unknown. Sometimes ­the ber­ry aneu­rysm of ­MMA ­can ­cause ­non trau­mat­ic extrad­u­ral hemat­o­mas. The asso­ci­a­tion menin­gio­ma-aneu­rysm of ­the mid­dle menin­geal ­artery is extreme­ly ­rare: ­only a ­case ­has ­been sig­nalled ­till ­now in lit­er­a­ture. In ­our ­case ­the ­patient ­was a 69 ­year-­old wom­an admit­ted in ­our depart­ment fol­low­ing an epi­lep­tic sei­zure. Neuroradiological stud­ies (­post-con­trast CT ­and RM) ­showed a menin­gio­ma of ­the ­right pter­ion. A pre­op­er­a­tive angio­gra­phy evi­den­zi­at­ed a ­big ­blush ­from ­the affer­enc­es of menin­gio­ma by ­the mid­dle menin­geal ­artery ­and, prox­i­mal­ly a ­small berr­ry aneu­rysm of ­this ­artery. Selective embol­iza­tion of ­the ­tumor ­and ­the aneu­rysm ­was per­formed pre­op­er­a­tive­ly ­with poly­vi­nyl par­ti­cles ­and ­straight plat­i­num ­coils. A cran­i­ot­o­my a sur­gi­cal resec­tion of ­the menin­gio­ma ­were per­formed. The ­role of ­the endo­vas­cu­lar treat­ment in ­the man­age­ment of ­these ­lesions is under­lined to ­decrease ­the ­risks of mor­bid­ity.

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