• Andrea Gerosa, Andrea Fanti, Bruno Del Sette, Andrea Bianco, Christian Cossandi, Emanuela Crobeddu, Sara Forgnone, Riccardo Fornaro, and Gabriele Panzarasa.
• Ospedale Civile S.S. Antonio e Biagio e Cesare Arrigo, Alessandria, University of Pavia, Pavia, Italy. Electronic address: andrea.gerosa@icloud.com.
• World Neurosurg. 2019 Aug 1; 128: 225-229.

BackgroundIntracranial 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.Case DescriptionWe report the case of a traumatic pseudoaneurysm of the right MMA treated with an endovascular approach and provide a review of the literature.ConclusionsAneurysms 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.Copyright © 2019 Elsevier Inc. All rights reserved.

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