Predictors of Middle Meningeal Artery-Related Vascular Diseases Associated with Blunt Head Trauma
Traumatic middle meningeal artery (MMA)–middle meningeal vein (MMV) fistula (MMA-MMV fistula) and MMA pseudoaneurysm are the 2 main MMA-related vascular diseases occurring after blunt head trauma. These are rare but known causes of delayed intracranial hemorrhage. This study investigated predictors...
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Veröffentlicht in: | World neurosurgery 2023-12, Vol.180, p.e667-e675 |
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creator | Kidani, Tomoki Ozaki, Tomohiko Nakajima, Shin Kanemura, Yonehiro Izutsu, Nobuyuki Kawamoto, Saki Taki, Kowashi Murakami, Keijiro Nishizawa, Naoki Kobayashi, Koji Fujimi, Yosuke Fujinaka, Toshiyuki |
description | Traumatic middle meningeal artery (MMA)–middle meningeal vein (MMV) fistula (MMA-MMV fistula) and MMA pseudoaneurysm are the 2 main MMA-related vascular diseases occurring after blunt head trauma. These are rare but known causes of delayed intracranial hemorrhage. This study investigated predictors that may aid in the diagnosis of these diseases.
In our department, screening digital subtraction angiography (DSA) is performed for patients with blunt head trauma accompanied by intracranial hemorrhage and skull or facial bone fracture. This study included 87 patients who underwent screening DSA without craniotomy from January 2019 to June 2023. The patients' clinical characteristics were retrospectively collected from the database. Statistical analysis was performed to examine the associations of various evaluation items with MMA-related vascular diseases.
The first DSA examination revealed 34 MMA-MMV fistulas and 1 MMA pseudoaneurysms. The second follow-up DSA examination revealed 13 MMA-MMV fistulas and four MMA pseudoaneurysms. Temporal/parietal bone fracture (odds ratio, 5.33; P = 0.0005; 95% confidence interval, 1.95–14.60) was significantly associated with MMA-related vascular diseases. Endovascular treatments were performed in 9 patients. All procedures were successfully completed without complications; no delayed bleeding was observed.
Temporal/parietal bone fracture in patients with blunt head trauma is a likely predictor of MMA-related vascular diseases. When initial head computed tomography reveals this pathology, we recommend careful imaging follow-up (e.g., DSA) and treatment as needed, while considering the possibility of MMA-related vascular diseases. |
doi_str_mv | 10.1016/j.wneu.2023.10.006 |
format | Article |
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In our department, screening digital subtraction angiography (DSA) is performed for patients with blunt head trauma accompanied by intracranial hemorrhage and skull or facial bone fracture. This study included 87 patients who underwent screening DSA without craniotomy from January 2019 to June 2023. The patients' clinical characteristics were retrospectively collected from the database. Statistical analysis was performed to examine the associations of various evaluation items with MMA-related vascular diseases.
The first DSA examination revealed 34 MMA-MMV fistulas and 1 MMA pseudoaneurysms. The second follow-up DSA examination revealed 13 MMA-MMV fistulas and four MMA pseudoaneurysms. Temporal/parietal bone fracture (odds ratio, 5.33; P = 0.0005; 95% confidence interval, 1.95–14.60) was significantly associated with MMA-related vascular diseases. Endovascular treatments were performed in 9 patients. All procedures were successfully completed without complications; no delayed bleeding was observed.
Temporal/parietal bone fracture in patients with blunt head trauma is a likely predictor of MMA-related vascular diseases. When initial head computed tomography reveals this pathology, we recommend careful imaging follow-up (e.g., DSA) and treatment as needed, while considering the possibility of MMA-related vascular diseases.</description><identifier>ISSN: 1878-8750</identifier><identifier>ISSN: 1878-8769</identifier><identifier>EISSN: 1878-8769</identifier><identifier>DOI: 10.1016/j.wneu.2023.10.006</identifier><identifier>PMID: 37813338</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Aneurysm, False - complications ; Aneurysm, False - etiology ; Blunt head trauma ; Fistula ; Head Injuries, Closed - complications ; Head Injuries, Closed - diagnostic imaging ; Humans ; Interventional treatment ; Intracranial Hemorrhages - complications ; Meningeal Arteries - diagnostic imaging ; Meningeal Arteries - injuries ; Middle meningeal artery ; Retrospective Studies ; Skull Fractures - complications ; Skull Fractures - diagnostic imaging ; Skull Fractures - surgery ; Traumatic arteriovenous fistula ; Traumatic pseudoaneurysm</subject><ispartof>World neurosurgery, 2023-12, Vol.180, p.e667-e675</ispartof><rights>2023 Elsevier Inc.</rights><rights>Copyright © 2023 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c307t-699539fd8af2985cb08f0144fd4800a3af96b21cff5166984b44779314a1ee903</cites><orcidid>0000-0002-0923-2858 ; 0000-0003-1558-4785 ; 0000-0002-1546-5666 ; 0000-0002-0406-0698 ; 0000-0002-1894-1824 ; 0000-0001-8241-9515 ; 0000-0003-3153-2600 ; 0000-0001-9808-9565</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27922,27923</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37813338$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kidani, Tomoki</creatorcontrib><creatorcontrib>Ozaki, Tomohiko</creatorcontrib><creatorcontrib>Nakajima, Shin</creatorcontrib><creatorcontrib>Kanemura, Yonehiro</creatorcontrib><creatorcontrib>Izutsu, Nobuyuki</creatorcontrib><creatorcontrib>Kawamoto, Saki</creatorcontrib><creatorcontrib>Taki, Kowashi</creatorcontrib><creatorcontrib>Murakami, Keijiro</creatorcontrib><creatorcontrib>Nishizawa, Naoki</creatorcontrib><creatorcontrib>Kobayashi, Koji</creatorcontrib><creatorcontrib>Fujimi, Yosuke</creatorcontrib><creatorcontrib>Fujinaka, Toshiyuki</creatorcontrib><title>Predictors of Middle Meningeal Artery-Related Vascular Diseases Associated with Blunt Head Trauma</title><title>World neurosurgery</title><addtitle>World Neurosurg</addtitle><description>Traumatic middle meningeal artery (MMA)–middle meningeal vein (MMV) fistula (MMA-MMV fistula) and MMA pseudoaneurysm are the 2 main MMA-related vascular diseases occurring after blunt head trauma. These are rare but known causes of delayed intracranial hemorrhage. This study investigated predictors that may aid in the diagnosis of these diseases.
In our department, screening digital subtraction angiography (DSA) is performed for patients with blunt head trauma accompanied by intracranial hemorrhage and skull or facial bone fracture. This study included 87 patients who underwent screening DSA without craniotomy from January 2019 to June 2023. The patients' clinical characteristics were retrospectively collected from the database. Statistical analysis was performed to examine the associations of various evaluation items with MMA-related vascular diseases.
The first DSA examination revealed 34 MMA-MMV fistulas and 1 MMA pseudoaneurysms. The second follow-up DSA examination revealed 13 MMA-MMV fistulas and four MMA pseudoaneurysms. Temporal/parietal bone fracture (odds ratio, 5.33; P = 0.0005; 95% confidence interval, 1.95–14.60) was significantly associated with MMA-related vascular diseases. Endovascular treatments were performed in 9 patients. All procedures were successfully completed without complications; no delayed bleeding was observed.
Temporal/parietal bone fracture in patients with blunt head trauma is a likely predictor of MMA-related vascular diseases. When initial head computed tomography reveals this pathology, we recommend careful imaging follow-up (e.g., DSA) and treatment as needed, while considering the possibility of MMA-related vascular diseases.</description><subject>Aneurysm, False - complications</subject><subject>Aneurysm, False - etiology</subject><subject>Blunt head trauma</subject><subject>Fistula</subject><subject>Head Injuries, Closed - complications</subject><subject>Head Injuries, Closed - diagnostic imaging</subject><subject>Humans</subject><subject>Interventional treatment</subject><subject>Intracranial Hemorrhages - complications</subject><subject>Meningeal Arteries - diagnostic imaging</subject><subject>Meningeal Arteries - injuries</subject><subject>Middle meningeal artery</subject><subject>Retrospective Studies</subject><subject>Skull Fractures - complications</subject><subject>Skull Fractures - diagnostic imaging</subject><subject>Skull Fractures - surgery</subject><subject>Traumatic arteriovenous fistula</subject><subject>Traumatic pseudoaneurysm</subject><issn>1878-8750</issn><issn>1878-8769</issn><issn>1878-8769</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE1LxDAQhoMorqh_wIPk6KU1afqRgJf1W3BRRL2GNJlolm67Jq3L_ntTVz06lxneeeeFeRA6oiSlhJan83TVwpBmJGNRSAkpt9Ae5RVPeFWK7b-5IBN0GMKcxGI05xXbRRNWccoY43tIPXowTvedD7izeOaMaQDPoHXtG6gGT30Pfp08QaN6MPhVBT00yuNLF0AFCHgaQqfd93Ll-nd83gxtj29BGfzs1bBQB2jHqibA4U_fRy_XV88Xt8n9w83dxfQ-0YxUfVIKUTBhDVc2E7zQNeGW0Dy3JueEKKasKOuMamsLWpaC53WeV5WILykKIAjbRyeb3KXvPgYIvVy4oKFpVAvdEGQWWbBKiKyI1mxj1b4LwYOVS-8Wyq8lJXKkK-dypCtHuqMW6caj45_8oV6A-Tv5ZRkNZxsDxC8_HXgZtINWR74edC9N5_7L_wJDJIrC</recordid><startdate>202312</startdate><enddate>202312</enddate><creator>Kidani, Tomoki</creator><creator>Ozaki, Tomohiko</creator><creator>Nakajima, Shin</creator><creator>Kanemura, Yonehiro</creator><creator>Izutsu, Nobuyuki</creator><creator>Kawamoto, Saki</creator><creator>Taki, Kowashi</creator><creator>Murakami, Keijiro</creator><creator>Nishizawa, Naoki</creator><creator>Kobayashi, Koji</creator><creator>Fujimi, Yosuke</creator><creator>Fujinaka, Toshiyuki</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-0923-2858</orcidid><orcidid>https://orcid.org/0000-0003-1558-4785</orcidid><orcidid>https://orcid.org/0000-0002-1546-5666</orcidid><orcidid>https://orcid.org/0000-0002-0406-0698</orcidid><orcidid>https://orcid.org/0000-0002-1894-1824</orcidid><orcidid>https://orcid.org/0000-0001-8241-9515</orcidid><orcidid>https://orcid.org/0000-0003-3153-2600</orcidid><orcidid>https://orcid.org/0000-0001-9808-9565</orcidid></search><sort><creationdate>202312</creationdate><title>Predictors of Middle Meningeal Artery-Related Vascular Diseases Associated with Blunt Head Trauma</title><author>Kidani, Tomoki ; Ozaki, Tomohiko ; Nakajima, Shin ; Kanemura, Yonehiro ; Izutsu, Nobuyuki ; Kawamoto, Saki ; Taki, Kowashi ; Murakami, Keijiro ; Nishizawa, Naoki ; Kobayashi, Koji ; Fujimi, Yosuke ; Fujinaka, Toshiyuki</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c307t-699539fd8af2985cb08f0144fd4800a3af96b21cff5166984b44779314a1ee903</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Aneurysm, False - complications</topic><topic>Aneurysm, False - etiology</topic><topic>Blunt head trauma</topic><topic>Fistula</topic><topic>Head Injuries, Closed - complications</topic><topic>Head Injuries, Closed - diagnostic imaging</topic><topic>Humans</topic><topic>Interventional treatment</topic><topic>Intracranial Hemorrhages - complications</topic><topic>Meningeal Arteries - diagnostic imaging</topic><topic>Meningeal Arteries - injuries</topic><topic>Middle meningeal artery</topic><topic>Retrospective Studies</topic><topic>Skull Fractures - complications</topic><topic>Skull Fractures - diagnostic imaging</topic><topic>Skull Fractures - surgery</topic><topic>Traumatic arteriovenous fistula</topic><topic>Traumatic pseudoaneurysm</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kidani, Tomoki</creatorcontrib><creatorcontrib>Ozaki, Tomohiko</creatorcontrib><creatorcontrib>Nakajima, Shin</creatorcontrib><creatorcontrib>Kanemura, Yonehiro</creatorcontrib><creatorcontrib>Izutsu, Nobuyuki</creatorcontrib><creatorcontrib>Kawamoto, Saki</creatorcontrib><creatorcontrib>Taki, Kowashi</creatorcontrib><creatorcontrib>Murakami, Keijiro</creatorcontrib><creatorcontrib>Nishizawa, Naoki</creatorcontrib><creatorcontrib>Kobayashi, Koji</creatorcontrib><creatorcontrib>Fujimi, Yosuke</creatorcontrib><creatorcontrib>Fujinaka, Toshiyuki</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>World neurosurgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kidani, Tomoki</au><au>Ozaki, Tomohiko</au><au>Nakajima, Shin</au><au>Kanemura, Yonehiro</au><au>Izutsu, Nobuyuki</au><au>Kawamoto, Saki</au><au>Taki, Kowashi</au><au>Murakami, Keijiro</au><au>Nishizawa, Naoki</au><au>Kobayashi, Koji</au><au>Fujimi, Yosuke</au><au>Fujinaka, Toshiyuki</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Predictors of Middle Meningeal Artery-Related Vascular Diseases Associated with Blunt Head Trauma</atitle><jtitle>World neurosurgery</jtitle><addtitle>World Neurosurg</addtitle><date>2023-12</date><risdate>2023</risdate><volume>180</volume><spage>e667</spage><epage>e675</epage><pages>e667-e675</pages><issn>1878-8750</issn><issn>1878-8769</issn><eissn>1878-8769</eissn><abstract>Traumatic middle meningeal artery (MMA)–middle meningeal vein (MMV) fistula (MMA-MMV fistula) and MMA pseudoaneurysm are the 2 main MMA-related vascular diseases occurring after blunt head trauma. These are rare but known causes of delayed intracranial hemorrhage. This study investigated predictors that may aid in the diagnosis of these diseases.
In our department, screening digital subtraction angiography (DSA) is performed for patients with blunt head trauma accompanied by intracranial hemorrhage and skull or facial bone fracture. This study included 87 patients who underwent screening DSA without craniotomy from January 2019 to June 2023. The patients' clinical characteristics were retrospectively collected from the database. Statistical analysis was performed to examine the associations of various evaluation items with MMA-related vascular diseases.
The first DSA examination revealed 34 MMA-MMV fistulas and 1 MMA pseudoaneurysms. The second follow-up DSA examination revealed 13 MMA-MMV fistulas and four MMA pseudoaneurysms. Temporal/parietal bone fracture (odds ratio, 5.33; P = 0.0005; 95% confidence interval, 1.95–14.60) was significantly associated with MMA-related vascular diseases. Endovascular treatments were performed in 9 patients. All procedures were successfully completed without complications; no delayed bleeding was observed.
Temporal/parietal bone fracture in patients with blunt head trauma is a likely predictor of MMA-related vascular diseases. When initial head computed tomography reveals this pathology, we recommend careful imaging follow-up (e.g., DSA) and treatment as needed, while considering the possibility of MMA-related vascular diseases.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>37813338</pmid><doi>10.1016/j.wneu.2023.10.006</doi><orcidid>https://orcid.org/0000-0002-0923-2858</orcidid><orcidid>https://orcid.org/0000-0003-1558-4785</orcidid><orcidid>https://orcid.org/0000-0002-1546-5666</orcidid><orcidid>https://orcid.org/0000-0002-0406-0698</orcidid><orcidid>https://orcid.org/0000-0002-1894-1824</orcidid><orcidid>https://orcid.org/0000-0001-8241-9515</orcidid><orcidid>https://orcid.org/0000-0003-3153-2600</orcidid><orcidid>https://orcid.org/0000-0001-9808-9565</orcidid></addata></record> |
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subjects | Aneurysm, False - complications Aneurysm, False - etiology Blunt head trauma Fistula Head Injuries, Closed - complications Head Injuries, Closed - diagnostic imaging Humans Interventional treatment Intracranial Hemorrhages - complications Meningeal Arteries - diagnostic imaging Meningeal Arteries - injuries Middle meningeal artery Retrospective Studies Skull Fractures - complications Skull Fractures - diagnostic imaging Skull Fractures - surgery Traumatic arteriovenous fistula Traumatic pseudoaneurysm |
title | Predictors of Middle Meningeal Artery-Related Vascular Diseases Associated with Blunt Head Trauma |
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