Rupture of posterior meningeal artery aneurysm: case report

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.