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At least 55 records · Page 3Linked to original sources
PubMed1995

[Posttraumatic pseudoaneurysm of the middle meningeal artery: a case report].

An epidural hematoma associated with posttraumatic pseudoaneurysm of the middle meningeal artery is a very rare clinical entity. Only 31 such cases have been reported in the literature. A 54-year-old man was admitted with lethargy and right hemiparesis. A skull X-ray film revealed a linear fracture in the left parietal and temporal bone, extending to the base of the skull. A brain CT scan disclosed an acute epidural hematoma over the left cerebral hemisphere, contusional hematoma in the right frontal lobe and thalamus, and subarachnoid hemorrhage in the left Sylvian fissure. During an emergency craniotomy a large epidural hematoma was evacuated and external decompression was performed. Angiography, which was performed about one month after the head injury, revealed an aneurysm of the middle meningeal artery. The aneurysm was removed to avoid delayed rupture at the time of cranioplasty. Histological diagnosis was pseudoaneurysm. We discussed the pathogenesis of a pseudoaneurysm of the meningeal artery and the necessity to pay attention to the presence of a pseudoaneurysm when an active bleeding point is not observed during surgery of the epidural hematoma.

Aneurysm, False↗
PubMed1989

Neuronal pathways to the rat middle meningeal artery revealed by retrograde tracing and immunocytochemistry.

The origin of nerve fibers to the middle meningeal artery of rat was studied by retrograde tracing in combination with immunocytochemistry. Application of the retrograde tracer, True blue (TB), to the middle meningeal artery labeled nerve cell bodies in the ipsilateral superior cervical ganglion, the otic ganglion, the sphenopalatine ganglion, the jugular-nodose ganglionic complex, the trigeminal ganglion and the cervical dorsal root ganglion at level C2. A few nerve cell bodies were labeled in the contralaterally placed ganglia. Judging from the number of labeled nerve cell bodies, the ipsilateral superior cervical ganglion, the otic ganglion, the sphenopalatine and the trigeminal ganglia contribute most to its innervation. A moderate supply of labeled nerve cell bodies was seen in the cervical dorsal root ganglion at level C2 whereas there were only few in the jugular-nodose ganglionic complex. The TB-labeled nerve cell bodies were further examined for the presence of neuropeptides. For that purpose antibodies against neuropeptide Y (NPY), vasoactive intestinal polypeptide (VIP), calcitonin gene-related peptide (CGRP) and substance P (SP) were used. Most of the TB-labeled nerve cell bodies in the superior cervical ganglion exhibited NPY-immunoreactivity. In the sphenopalatine and otic ganglia the majority of the TB-labelled neurons were VIP-immunoreactive whereas in the trigeminal and dorsal root ganglion at level C2 the majority of labeled nerve cell bodies displayed CGRP-immunofluorescence and a minority of the labeled nerve cell bodies were substance P-immunoreactive. Together the findings indicate that several ganglia project to the middle meningeal artery of the rat and that many neuropeptides are involved in vasomotor control and in mediation of afferent information.

Animals↗
PubMed2002

Traumatic false aneurysm of the middle meningeal artery causing an intracerebral hemorrhage: case report and literature review.

BACKGROUND: Traumatic false aneurysms of the meningeal arteries are rare. We report an unusual case of an intracerebral hematoma caused by the rupture of a traumatic aneurysm of the middle meningeal artery. CASE DESCRIPTION: A 64-year-old woman suffered a massive spontaneous intracerebral fronto-temporal hemorrhage. Cerebral angiogram revealed a pseudoaneurysm of the middle meningeal artery. At operation, a skull fracture was discovered in the vicinity of the aneurysm. The patient died the day after surgery. CONCLUSION: Although rare, traumatic meningeal aneurysms should be considered as a possible cause of cerebral hematoma. Because of their potential morbidity and mortality, they must be detected and treated rapidly.

Aneurysm, False↗
PubMed2005

The cranio-orbital foramen, the groove on the lateral wall of the human orbit, and the orbital branch of the middle meningeal artery.

The cranio-orbital foramen, a foramen in the lateral wall of the orbit, contains an anastomosis between the anterior branch of the middle meningeal artery and the lacrimal artery. Previous workers have speculated that the groove starting either from the cranio-orbital foramen or the lateral extremity of the superior orbital fissure contains the anastomotic artery. We investigated the cranio-orbital foramen and the groove on the lateral wall of the orbit in a series of 170 dried adult human skulls, and the course of the orbital branch of the middle meningeal artery in 74 specimens from 37 cadavers. We observed the cranio-orbital foramen in 141 skulls (82.9%). It was unilateral in 55 (32.4%) and bilateral in 86 (50.6%) skulls. The groove on the lateral wall of the human orbit was observed in 122 skulls (71.8%). It was unilateral in 40 (23.5%) and bilateral in 82 (48.2%). The groove on the lateral wall of the orbit started from the cranio-orbital foramen in 20 skulls (11.8%). The orbital branch of the middle meningeal artery was found in 48 cadaveric specimens (64.9%): 32 (43.2%) passed through the cranio-orbital foramen and 12 (16.2%) passed through the superior orbital fissure. In four specimens (5.4%), orbital branches of the middle meningeal artery passed through both the superior orbital fissure and the cranio-orbital foramen. The anatomy of the cranio-orbital foramen and the course of the orbital branch should be well known by surgeons reconstructing the anterior base of the skull, the orbit after orbital base surgery, and during excision of meningiomas.

Cadaver↗
PubMed1979

Extradural hematoma associated with traumatic middle meningeal artery pseudoaneurysm: report of two cases.

Two new cases of extradural hematoma associated with traumatic middle meningeal artery pseudoaneurysm are presented. Sixteen such cases have previously been reported in the literature. A 22-year-old man and a 17-year-old woman each developed marked neurological deficits after head injury. In each case percutaneous common carotid angiography demonstrated a conspicuous aneurysmatic sac on the middle meningeal artery, as well as displacement of major intracranial vessels and a surrounding avascular area. At operation the extradural clot was removed and the middle meningeal artery sac was verified. Both patients recovered uneventfully. Histological analysis of one of the specimens was performed.

Adolescent↗
PubMed1995

Classification of the ophthalmic artery that arises from the middle meningeal artery in Japanese adults.

In a study of Japanese adults, we found that the orbital branch (OB) passing through the superior orbital fissure frequently anastomosed with the lacrimal artery or the ophthalmic artery (12/20). However, the OB passing through the meningo-orbital foramen (mof) only associationaly anastomosed with branches of the ophthalmic artery (4/79). Furthermore, the OB in the orbit, excluding the lacrimal gland as previously reported. We examined 116 cases in which the OB passed through the mof in 129 adult Japanese cadavers (45.0% in 258 sides). The OB passing through the mof was always distributed to the periorbital region and the area that it supplied was limited to the periorbita in about half of those cases. In another half of the cases (58/116), the area supplied included the lacrimal gland.

Adult↗
PubMed1991

Histamine receptors in the isolated human middle meningeal artery. A comparison with cerebral and temporal arteries.

The subtypes of histamine receptors mediating dilatation of human meningeal arteries have been tested in vitro, using "selective" antagonists, and compared with cerebral and temporal arteries previously examined. Dilatory responses were tested after preconstriction with prostaglandin F2 alpha. Both mepyramine and cimetidine caused a parallel shift to the right of the histamine concentration-response curve, suggesting the presence of both H1- and H2-receptors. Combined treatment with mepyramine and cimetidine caused further displacement of the concentration-response curve to the right. Schild analysis indicated pA2 values of 6.3 for cimetidine and 9.8 for mepyramine in situations of near complete blockade of either of the receptors. Both H1- and H2-receptors seem of importance for the histamine-induced dilatation in meningeal arteries and neither appear to dominate. The data considered in conjunction with our previous findings support the finding that experimental histamine-induced headache due to vasodilatation is intracranial of origin.

Adult↗
PubMed2002

[A case of post-traumatic pseudoaneurysm on the posterio meningeal artery].

A case is reported of post-traumatic delayed appearance of a pseudoaneurysm on the posterior meningeal artery. In the immediate post-traumatic stage, the patient had mild disturbance of consciousness, mild subarachnoid hemorrhage, and mid-line skull fracture of the posterior cranial fossa. At 15 hours after the trauma, the patient suddenly developed deep coma and respiratory arrest. CT scanning showed further spreading of the subarachnoid hemorrhage and newly detected subdural hemorrhage. After the patient regained spontaneous respiration, cerebral angiography was performed 24 hours after admission. This initial angiography showed no aneurysm, but at 17 days after the trauma, follow-up angiography demonstrated the delayed appearance of an aneurysmal dilatation on the posterior meningeal artery. The aneurysm was resected surgically and proved to be a pseudoaneurysm. Having developed normal pressure hydrocephalus afterwards, the patient received a V-P shunt, and was discharged 150 days after the trauma with no major neurological deficit. We discussed the indication for and timing of angiography for detecting pseudoaneurysms. Posterior meningeal artery pseudoaneurysms should be resected surgically, because intravascular surgery through the vertebral artery involves considerable risk of embolic complications.

Aneurysm, False↗
PubMedDate not supplied

Variations of the ophthalmic and middle meningeal arteries: relation to the embryonic stapedial artery.

Recognition of the anatomic variations of the ophthalmic and middle meningeal arteries may be pertinent in tailoring the angiographic study to resolve a given clinical problem. An understanding of these anomalies is based on knowledge of the normal embryology. Unfortunately some early aspects of vascular development remain obscure. Fragmentary observations gleaned from the embryologic literature were correlated with selective and/or subselective angiography performed in 42 patients with such anomalies. This analysis has provided the basis for a tenable scheme for development of the ophthalmic and middle meningeal arteries as they relate to the embryonic stapedial artery. A classification for anomalies of these arteries is proposed based on deviation from this normal embryologic mechanism.

Aorta↗
PubMed1997

Iatrogenic arteriovenous fistula of the middle meningeal artery caused during embolization for meningioma--case report.

A 73-year-old female developed middle meningeal arteriovenous fistula during embolization of a falx meningioma. The cause of this complication was thought to be perforation by the guide wire during catheterization at the sharp bend in the sphenoidal portion of the middle meningeal artery. Embolization of the fistula and the feeding artery to the meningioma with polyvinyl alcohol particles 250-355 microns size resulted in complete obliteration of the fistula. Computed tomography showed no epidural or subdural hematoma. Introduction of the microcatheter beyond the sharp bend in the middle meningeal artery should not be attempted to avoid the possibility of iatrogenic middle meningeal arteriovenous fistula.

Aged↗
PubMed2002

Traumatic middle meningeal artery pseudoaneurysm and subsequent fistula formation with the cavernous sinus: case report.

BACKGROUND: A combination of pseudoaneurysm and arteriovenous fistula of the middle meningeal artery is rare. We describe a case of traumatic pseudoaneurysm of the middle meningeal artery, which subsequently formed a fistula with the cavernous sinus. CASE DESCRIPTION: A 23-year-old man suffered from blunt head trauma and skull fractures. Sixteen days later, he suddenly experienced headache and a bruit was auscultated over the left ear. Three-dimensional computed tomographic angiography revealed dilatation of the left middle meningeal artery. The dilation proved to be a pseudoaneurysm on cerebral angiograms and it was also found to have formed a fistula with the cavernous sinus. Both lesions were successfully obliterated by endovascular embolization using microcoils. CONCLUSION: Head injury may lead to asymptomatic pseudoaneurysm or dural arteriovenous fistula. Neurosurgeons should always bear in mind the possibility of such vascular injuries after blunt head trauma to prevent any hemorrhagic complications.

Adult↗
PubMed2006

Effects of current and prospective antimigraine drugs on the porcine isolated meningeal artery.

Vasoconstriction to agonists at serotonin (5-hydroxytryptamine; 5-HT) receptors and alpha-adrenoceptors, as well as vasodilatation induced by alpha-CGRP, have been well described in the porcine carotid circulation in vivo. The present study sets out to investigate the effects of current and prospective antimigraine drugs on porcine meningeal artery segments in vitro. Sumatriptan, ergotamine, dihydroergotamine, isometheptene and clonidine failed to contract the meningeal artery, but 5-HT, noradrenaline and phenylephrine induced concentration-dependent contractions. The contractions to 5-HT were competitively antagonized by the 5-HT(2A) receptor antagonist ketanserin, whilst those to noradrenaline were antagonized by alpha(1)-(prazosin), alpha(2)-(rauwolscine and yohimbine) and alpha(2C/2B)-(OPC-28326) adrenoceptor antagonists. Whilst dobutamine and salbutamol were ineffective, alpha-CGRP produced concentration-dependent relaxations that were antagonized by the CGRP(1) receptor antagonist olcegepant. In agreement with their lack of contractile effect, sumatriptan and ergotamine failed to influence forskolin-stimulated cyclic AMP accumulation in the porcine meningeal artery; in contrast, both compounds decreased forskolin-stimulated cyclic AMP accumulation in the human isolated saphenous vein, where they induced contractions. Finally, using RT-PCR, we could demonstrate the presence of mRNAs encoding for several 5-HT receptors (5-HT(1B), 5-HT(1D), 5-HT(1F), 5-HT(2A) and 5-HT(7)) and adrenoceptors (alpha(1A), alpha(1B), alpha(1D), alpha(2A), alpha(2B), alpha(2C), beta(1) and beta(2)), as well as that for the calcitonin receptor like receptor, a component of the CGRP(1) receptor. These results suggest that: (i) the porcine meningeal artery may not be involved in the vasoconstriction of the carotid vascular bed elicited by antimigraine drugs in anaesthetized pigs, and (ii) the mismatch between the presence of receptor mRNA and the lack of response to sumatriptan, dobutamine and salbutamol implies that mRNAs for the 5-HT(1B) receptor and beta(1)- and beta(2)-adrenoceptors are probably unstable, or that their density is too low for being translated as receptor protein in sufficient quantities.

Adrenergic alpha-Agonists↗
PubMed1978

Extradural hematoma due to traumatic pseudoaneurysm of middle meningeal artery.

Extradural hematoma due to rupture of post-traumatic pseudoaneurysm of the middle meningeal artery is a very rare clinical entity. Only fourteen such cases have been reported in the literature. A 52-year-old, right-handed Mexican male was admitted with motor aphasia and right-sided signs but no history of unconsciousness. He had been struck by an automobile almost 24 hours earlier. His neurological signs appeared shortly thereafter. A left temporoparietal linear fracture of the skull was recognized as well as a fracture of the right knee. Angiography revealed a lenticular parietal avascular area with depression of the middle cerebral artery and a shift of the anterior cerebral artery. An aneurysm was observed on the left middle meningeal artery below the skull fracture. At craniotomy a large extradural hematoma was evacuated and the aneurysm removed. The patient had a complete recovery.

Brain Injuries↗
PubMed2006

Characterisation of CGRP receptors in the human isolated middle meningeal artery.

Although the understanding of migraine pathophysiology is still incomplete, there seems to be little doubt that dilatation of cranial blood vessels, including meningeal arteries, is involved in the headache phase of migraine. Since calcitonin gene-related peptide (CGRP) has been implicated in this vasodilatation, the present study set out to compare the relaxant effects of the endogenous ligand h-alphaCGRP, and [ethylamide-Cys(2,7)]h-alphaCGRP ([Cys(Et)(2,7)]h-alphaCGRP), a CGRP(2) receptor agonist, on human isolated middle meningeal artery segments, precontracted with KCl. Classical Schild plot analysis was used to characterise the receptor population in this artery using BIBN4096BS and h-alphaCGRP(8-37) as antagonists. h-alphaCGRP relaxed arterial segments more potently than [Cys(Et)(2,7)]h-alphaCGRP (pEC(50): 8.51+/-0.16 and 7.48+/-0.24, respectively), while the maximal responses to these agonists were not significantly different. BIBN4096BS equipotently blocked the relaxations induced by both agonists with a pA(2) of approximately 10 and with a Schild plot slope not significantly different from unity. h-alphaCGRP(8-37) also antagonised the response to h-alphaCGRP with a pA(2) of 6.46+/-0.16 and a Schild plot slope not different from unity. Furthermore, the results obtained from RT-PCR studies confirmed the presence of all the essential components required for a functional CGRP(1) receptor in these arteries. Considering the high antagonist potency of BIBN4096BS, coupled to the lower agonist potency of [Cys (Et)(2,7)]h-alphaCGRP, it is reasonable to suggest a predominant role of CGRP(1) receptors in the human middle meningeal artery. This view is reinforced by Schild plot analysis, which revealed a slope of unity in all experiments, giving further evidence for a homogeneous CGRP receptor population in this vascular preparation.

Calcitonin Gene-Related Peptide↗
PubMedDate not supplied

True aneurysm of the middle meningeal artery. Case report.

We report the case of a true aneurysm of the middle meningeal artery (MMA) associated with no other pathological findings. After a review of the literature, we emphasize that this case is not associated either with skull traumas, with vascular hypertension or with Paget's disease of the skull. Histological examination and neuroradiological findings confirm the suspicion that this is a case of true aneurysm of the middle meningeal artery.

Cerebral Angiography↗
PubMedDate not supplied

Distribution and effects of neuropeptide Y, vasoactive intestinal peptide, substance P, and calcitonin gene-related peptide in human middle meningeal arteries: comparison with cerebral and temporal arteries.

A sparse to moderate supply of nerve fibers containing neuropeptide Y-like immunoreactivity (NPY-LI), vasoactive intestinal polypeptide (VIP-LI), substance P (SP-LI), and calcitonin gene-related peptide (CGRP-LI) was demonstrated in the walls of human middle meningeal arteries. Comparison with similar studies on human cerebral and temporal arteries indicated a similar distribution and density. The immunoreactive material in all three arterial regions was characterized by reversed-phase high pressure liquid chromatography (HPLC) and radioimmunoassay (RIA). The major peak of NPY-LI, VIP-LI, SP-LI, and CGRP-LI in each extract eluted approximately with the same elution volume as that of the corresponding synthetic analogues. The concentration of NPY in the middle meningeal arteries was lower as compared to the temporal arteries. Low concentrations of SP-LI and CGRP-LI were found in the middle meningeal arteries as compared to the cerebral arteries. In isolated ring segments of human middle meningeal and cerebral arteries, NPY caused vasoconstriction but did not potentiate the contractile response of noradrenaline. In the temporal artery, NPY did not induce contraction but potentiated the vasoconstrictor response to noradrenaline. Vasoactive intestinal polypeptide, peptide histidine methionine-27, SP, neurokinin A, and CGRP relaxed all three types of cephalic arteries. The peptide effects were not antagonized by propranolol, atropine, or cimetidine. Comparison of the responses to VIP and SP of vessels from the different regions showed a similar pattern of reactivity. The response to SP was slightly (p less than 0.05) more potent, whereas the responses to CGRP were less potent in the middle meningeal as compared to that in cerebral (p less than 0.005) vessels.

Acetylcholine↗
PubMed1973

An anomalous origin of the middle meningeal artery.

A human skull is described in which the middle meningeal artery probably arose bilaterally from the lacrimal artery. The branches of the middle meningeal vessels, however, were normal both in their position and distribution. This anomaly is a rare occurrence and is of neurosurgical importance.

Adult↗