Initial non-contrasted CT brain, showing the basilar skull fracture.

Initial non-contrasted CT brain, showing the basilar skull fracture.

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Background Meningeal arterial injuries represent <1% of all blunt traumatic brain injuries (TBIs). Middle meningeal artery (MMA) lesions comprise the majority. However, there is little clinical data on posterior meningeal artery (PMA) injuries. Case Report. A 69-year-old man was brought to our trauma center after sustaining a fall inside a warehous...

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... 3% hypertonic saline, and 1 g loading doses of both tranexamic acid and levetiracetam given the clinical picture of severe home clopidogrel use. Emergent non-contrasted CT brain demonstrated a TBI, a basilar skull fracture, a diffuse subarachnoid hemorrhages, associated cerebral edema, but no midline shift, or uncal or falcine herniation ( Fig. 1). Neurosurgery placed an emergent external ventricular drain. The initial pressures were below 20 mm Hg. Based on clinical suspicion, neurosurgery requested immediate CT angiography (CTA) of the head after ventriculostomy, which revealed a hyperintense focus of posterior cranial fossa blood products (Fig. 2). Neurointerventional ...

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p>An aneurysm of the posterior meningeal artery is a rare pathology. However, rupture of this aneurysm can lead to serious consequences for the patient's health. For the surgical treatment, both microsurgical and endovascular methods are used. A 19-year-old patient was admitted to our hospital on day 21 after suffering a subarachnoid-ventricular hemorrhage from an aneurysm of the right posterior meningeal artery. On admission, the patient complained of a headache. Cerebellar symptoms were noted in the neurological status. According to digital subtraction angiography, the patient had an anastomosis between the posterior meningeal artery and the hypoplastic p1-segment of the right posterior inferior cerebellar artery distal to the aneurysm. Endovascular method was used to occlude the aneurysm with a detachable coil. The patient was discharged on the third day with total regress of neurological symptoms. Control cerebral angiography 3 months later showed thrombosis of the aneurysm with the supporting segment of the parent artery, as well as restructuring of the main blood flow of this basin through the previously hypoplastic posterior inferior cerebellar artery. In the literature, we found only 9 such cases. Endovascular treatment of this pathology is, in our opinion, effective and safe, and the presence of an anastomosis distal to the aneurysm made it possible to avoid disruption of blood supply in the vascular basin of the affected artery. Received 21 September 2021. Revised 11 October 2021. Accepted 18 October 2021. Funding: The study did not have sponsorship. Conflict of interest: Authors declare no conflict of interest. Contribution of the authors: The authors contributed equally to this article.</p