Occluded middle cerebral artery vascular stump mimicking aneurysm: case report and review of literature

The stump of an occluded middle cerebral artery [MCA] is a rare but important aneurysm mimic. A 57-year-old male was admitted due to recurrent onset of transient ischemic attack. Computed tomography angiography [CTA] and digital subtraction angiography [DSA] showed a total obstruction in the right MCA with moyamoya phenomenon at distal trunks and a protruding lesion in the left MCA bifurcation. The patient was diagnosed with left MCA bifurcation aneurysm. Intraoperatively, the lesion was found to be an occluded right MCA stump. Encephalomyoarteriosynangiosis was performed, and the patient remained symptom-free at the 6-month follow-up. The possibility of a vascular stump should be considered when an aneurismal lesion is present at the MCA bifurcation with moyamoya phenomenon at distal trunks

Acute supratentorial bilateral giant extradural haematomas as a postoperative complication of resection of recurrent meningioma at the skull base

We report one rare case of an acute bilateral giant extradural haematoma as a postoperative complication of the resection of recurrent meningioma. The patient underwent meningioma resection at the sellar region five times. The patient recovered well after the first four surgeries. The resection went well during the fifth operation. However, acute supratentorial remote giant epidural haematomas developed in the bilateral hemispheres one hour after the operation, leading to the death of the patient. Therefore, great care must be taken to prevent the occurrence of such haematomas