Abstract
We present a previously undescribed variant of the middle cerebral artery (MCA) protruding through a defect in the temporal bone, associated with a large arteriovenous malformation (AVM). The patient, a 59-year-old male, presented with a large right frontoparietal AVM with feeding aneurysms and a recent haemorrhage. Preoperative imaging demonstrated a tortuous right MCA feeder abutting the anterosuperior temporal bone in the region of the pterion. An associated temporal bone defect was visible. The patient underwent a pterional craniotomy for surgical clipping of aneurysms associated with the AVM. On reflection of the temporalis muscle, the MCA branch was transected as it coursed through a defect in the temporal bone. This patient demonstrates that the MCA may deviate from its usual anatomy and herniate through a defect in the skull. Because a pterional craniotomy is such a common surgical approach, knowledge and anticipation of such anatomic variants are essential to avoid catastrophic vascular injury during surgery.
| Language | English |
|---|---|
| Pages | 1591-1593 |
| Number of pages | 3 |
| Journal | Journal of Clinical Neuroscience |
| Volume | 19 |
| Issue number | 11 |
| DOIs | |
| Publication status | Published - Nov 2012 |
Fingerprint
Cite this
}
Herniation of an enlarged middle cerebral artery through a temporal bone defect in association with an arteriovenous malformation. / Raley, Darryl Alan; Davidson, Andrew Stewart; Morgan, Michael Kerin.
In: Journal of Clinical Neuroscience, Vol. 19, No. 11, 11.2012, p. 1591-1593.Research output: Contribution to journal › Article › Research › peer-review
TY - JOUR
T1 - Herniation of an enlarged middle cerebral artery through a temporal bone defect in association with an arteriovenous malformation
AU - Raley, Darryl Alan
AU - Davidson, Andrew Stewart
AU - Morgan, Michael Kerin
PY - 2012/11
Y1 - 2012/11
N2 - We present a previously undescribed variant of the middle cerebral artery (MCA) protruding through a defect in the temporal bone, associated with a large arteriovenous malformation (AVM). The patient, a 59-year-old male, presented with a large right frontoparietal AVM with feeding aneurysms and a recent haemorrhage. Preoperative imaging demonstrated a tortuous right MCA feeder abutting the anterosuperior temporal bone in the region of the pterion. An associated temporal bone defect was visible. The patient underwent a pterional craniotomy for surgical clipping of aneurysms associated with the AVM. On reflection of the temporalis muscle, the MCA branch was transected as it coursed through a defect in the temporal bone. This patient demonstrates that the MCA may deviate from its usual anatomy and herniate through a defect in the skull. Because a pterional craniotomy is such a common surgical approach, knowledge and anticipation of such anatomic variants are essential to avoid catastrophic vascular injury during surgery.
AB - We present a previously undescribed variant of the middle cerebral artery (MCA) protruding through a defect in the temporal bone, associated with a large arteriovenous malformation (AVM). The patient, a 59-year-old male, presented with a large right frontoparietal AVM with feeding aneurysms and a recent haemorrhage. Preoperative imaging demonstrated a tortuous right MCA feeder abutting the anterosuperior temporal bone in the region of the pterion. An associated temporal bone defect was visible. The patient underwent a pterional craniotomy for surgical clipping of aneurysms associated with the AVM. On reflection of the temporalis muscle, the MCA branch was transected as it coursed through a defect in the temporal bone. This patient demonstrates that the MCA may deviate from its usual anatomy and herniate through a defect in the skull. Because a pterional craniotomy is such a common surgical approach, knowledge and anticipation of such anatomic variants are essential to avoid catastrophic vascular injury during surgery.
UR - http://www.scopus.com/inward/record.url?scp=84867098988&partnerID=8YFLogxK
U2 - 10.1016/j.jocn.2012.03.020
DO - 10.1016/j.jocn.2012.03.020
M3 - Article
VL - 19
SP - 1591
EP - 1593
JO - Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia
T2 - Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia
JF - Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia
SN - 0967-5868
IS - 11
ER -