Background: Pseudoaneuryms of the MMA are rare lesions, accounting for less than 1% of all intracranial aneurysms.
Case Description: We report a case of a spontaneous intracerebral hematoma that DSA revealed as ispilateral traumatic PMMA. The lesion was managed through an endovascular approach, and definitive embolization of pseudoaneurysm and parent vessel with histoacryl injection was carried out. Recovery and follow-up were uneventful. We discuss the management of those lesions, emphasizing the current neuroendovascular tools and techniques.
Conclusion: Pseudoaneurysm of the MMA is uncommon but has a potential aggressive natural history. As it can occur with different patterns of intracranial hemorrhage, the external carotid arteries have to be included in hemorrhagic investigational DSA. Once diagnosed, it must be treated. The minimally invasive endovascular approach and definitive embolization of pseudoaneurysm and parent vessel with histoacryl injection are safe and effective.
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