This entity has been described in multiple case reports and small series, mostly several decades ago. It is familiar to those who do post-trauma angiography, but perhaps less so to others
This man presented with multiple foci of intracranial hemorrhage. A left parietal skull fracture (black) intersects the groove of the middle meningeal artery (pink)
Angiography micro injections (all stereo views) shows multiple foci of contrast extravasation and early filling of the middle meningeal venous sinus. It has a characteristic tram-track appearance and is, embryologically, a sinus rather than a vein
Later phase
Late phase, nice tram-track of MM venous sinus
Frontal stereo views
Late phase frontal stereo images
nBCA glue cast
Post-embo ECA injections
Companion Cases on Neuroangio
For further reading, google “traumatic middle meningeal artery fistula”
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