{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T01:00:57Z","timestamp":1784682057534,"version":"3.55.0"},"reference-count":14,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","license":[{"start":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T00:00:00Z","timestamp":1784505600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurosurg Case Lessons"],"published-print":{"date-parts":[[2026,7,20]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Traumatic intracranial pseudoaneurysms are rare, and those located between the dural layers (interdural space) are exceptionally uncommon. The authors describe a delayed pseudoaneurysm arising from a distal middle cerebral artery branch, with multimodal findings most consistent with an interdural location.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>A 56-year-old man sustained a fall-related head injury with right frontal contusion, frontal bone fracture, and superior orbital wall fractures. Initial 3D CT angiography (3D-CTA) showed no vascular abnormality; however, follow-up 3D-CTA on day 20 revealed a de novo 4-mm pseudoaneurysm of the lateral orbitofrontal artery (LOFA) adjacent to the fracture. During surgical trapping, the parent LOFA was observed to enter and exit the dural layer proximally and distally, respectively, and the lesion was resected en bloc with the adherent dura. Histopathological analysis confirmed the lesion as a pseudoaneurysm, and the interdural location was inferred from the integration of intraoperative anatomical findings and gross specimen continuity with the dura.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>This case suggests that traumatic pseudoaneurysms from intracranial arteries may rarely develop in an interdural location and may present with a delayed onset. Repeat vascular imaging may be considered for selected high-risk fractures anatomically adjacent to intracranial arterial pathways, even when the initial CTA findings are negative.<\/jats:p>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/thejns.org\/doi\/10.3171\/CASE26393\">https:\/\/thejns.org\/doi\/10.3171\/CASE26393<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case26393","type":"journal-article","created":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T00:01:15Z","timestamp":1784678475000},"source":"Crossref","is-referenced-by-count":0,"title":["Traumatic pseudoaneurysm of a distal middle cerebral artery branch with findings suggestive of an interdural location: illustrative case"],"prefix":"10.3171","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-7384-3744","authenticated-orcid":true,"given":"Toshiaki","family":"Inomo","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Aichi Medical University, Nagakute, Aichi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-9338-205X","authenticated-orcid":true,"given":"Eiji","family":"Ito","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Aichi Medical University, Nagakute, Aichi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yusuke","family":"Sakamoto","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Aichi Medical University, Nagakute, Aichi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0849-9665","authenticated-orcid":true,"given":"Akiko","family":"Ohashi","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Pathology, Aichi Medical University, Nagakute, Aichi, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mao","family":"Yokota","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Aichi Medical University, Nagakute, Aichi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tadashi","family":"Watanabe","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Aichi Medical University, Nagakute, Aichi"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"bib1","series-title":"Front Neurol","first-page":"582","article-title":"Intracranial pseudoaneurysms: evaluation and management","volume":"11","author":"Zheng","year":"2020","unstructured":"Zheng YLu ZShen JXu F.Intracranial pseudoaneurysms: evaluation and management. Front Neurol. 2020;11:582. doi:10.3389\/fneur.2020.00582"},{"issue":"3","key":"bib2","series-title":"J Vasc Interv Neurol","first-page":"79","article-title":"Traumatic intracranial \u00adaneurysm formation following closed head injury","volume":"1","author":"Miley","year":"2008","unstructured":"Miley JTRodriguez GJQureshi AI.Traumatic intracranial \u00adaneurysm formation following closed head injury. J Vasc Interv Neurol. 2008;1(3):79-82."},{"issue":"1","key":"bib3","series-title":"Neurosurg Focus","first-page":"e4","article-title":"Traumatic intracranial aneurysms","volume":"8","author":"Larson","year":"2000","unstructured":"Larson PSReisner AMorassutti DJAbdulhadi BHarpring JE.Traumatic intracranial aneurysms. Neurosurg Focus. 2000;8(1):e4. doi:10.3171\/foc.2000.8.1.1829"},{"issue":"6","key":"bib4","series-title":"J Clin Neurosci","first-page":"609","article-title":"Traumatic intracranial aneurysm: a brief review","volume":"15","author":"Dubey","year":"2008","unstructured":"Dubey ASung WSChen YYTraumatic intracranial aneurysm: a brief review. J Clin Neurosci. 2008;15(6):609-612. doi:10.1016\/j.jocn.2007.11.006"},{"key":"bib5","series-title":"Front Neurol","first-page":"1173821","article-title":"Case report: an overlooked complication of the dural suture after craniotomy: pseudoaneurysm of the middle meningeal artery with endovascular resolution","volume":"14","author":"Xu","year":"2023","unstructured":"Xu YLi X.Case report: an overlooked complication of the dural suture after craniotomy: pseudoaneurysm of the middle meningeal artery with endovascular resolution. Front Neurol. 2023;14:1173821. doi:10.3389\/fneur.2023.1173821"},{"issue":"12","key":"bib6","series-title":"Acta Neurochir (Wien)","first-page":"3215","article-title":"Hemorrhage due to a pseudoaneurysm on a dural-pial anastomosis after decompression for Chiari malformation type I: case report","volume":"164","author":"Dahl","year":"2022","unstructured":"Dahl RHKelsen JHansen KHauerberg JBenndorf G.Hemorrhage due to a pseudoaneurysm on a dural-pial anastomosis after decompression for Chiari malformation type I: case report. Acta Neurochir (Wien). 2022;164(12):3215-3219. doi:10.1007\/s00701-022-05341-4"},{"issue":"1","key":"bib7","series-title":"Neurosurg Rev","first-page":"355","article-title":"Delayed traumatic intracranial aneurysms: literature review and case series","volume":"47","author":"Lefevre","year":"2024","unstructured":"Lefevre EFawaz RPremat KDelayed traumatic intracranial aneurysms: literature review and case series. Neurosurg Rev. 2024;47(1):355. doi:10.1007\/s10143-024-02586-8"},{"issue":"3","key":"bib8","series-title":"Neurol Med Chir (Tokyo)","first-page":"130","article-title":"Ruptured traumatic aneurysm after trivial injury mimicking acute spontaneous subdural hematoma\u2014case report","volume":"43","author":"Murakami","year":"2003","unstructured":"Murakami MKakita KHosokawa Y.Ruptured traumatic aneurysm after trivial injury mimicking acute spontaneous subdural hematoma\u2014case report. Neurol Med Chir (Tokyo). 2003;43(3):130-133. doi:10.2176\/nmc.43.130"},{"key":"bib9","series-title":"Surg Neurol Int","first-page":"247","article-title":"Ruptured traumatic pseudoaneurysm of the middle cerebral artery following minor trauma treated with an MCA-MCA bypass: a case report","volume":"15","author":"Tirado","year":"2024","unstructured":"Tirado SRBass DIFeroze AJohnston BBi WLDu R.Ruptured traumatic pseudoaneurysm of the middle cerebral artery following minor trauma treated with an MCA-MCA bypass: a case report. Surg Neurol Int. 2024;15:247. doi:10.25259\/SNI_373_2024"},{"key":"bib10","series-title":"World Neurosurg","first-page":"225","article-title":"Posttraumatic middle meningeal artery pseudoaneurysm: case report and review of the literature","volume":"128","author":"Gerosa","year":"2019","unstructured":"Gerosa AFanti ADel Sette BPosttraumatic middle meningeal artery pseudoaneurysm: case report and review of the literature. World Neurosurg. 2019;128:225-229. doi:10.1016\/j.wneu.2019.05.030"},{"key":"bib11","series-title":"Surg Neurol Int","first-page":"1","article-title":"Surgical resection of a large posttraumatic middle meningeal artery pseudoaneurysm with associated epidural hematoma","volume":"12","author":"McCormack","year":"2021","unstructured":"McCormack RMChen AYSchwartz LMLewis CTKitagawa RS.Surgical resection of a large posttraumatic middle meningeal artery pseudoaneurysm with associated epidural hematoma. Surg Neurol Int. 2021;12:1. doi:10.25259\/SNI_209_2020"},{"issue":"2","key":"bib12","series-title":"J Neurosurg","first-page":"151","article-title":"Microsurgical anatomy of the middle cerebral artery","volume":"54","author":"Gibo","year":"1981","unstructured":"Gibo HCarver CCRhoton ALJrLenkey CMitchell RJ.Microsurgical anatomy of the middle cerebral artery. J Neurosurg. 1981;54(2):151-169. doi:10.3171\/jns.1981.54.2.0151"},{"issue":"1","key":"bib13","series-title":"Neurotrauma Rep","first-page":"73","article-title":"Locked-in syndrome after traumatic basilar artery entrapment within a clivus fracture: a case report and review of the literature","volume":"1","author":"Lagrand","year":"2020","unstructured":"Lagrand TJBruijnes VAJVan der Stouwe AMMDeckers EAMazuri AJacobs B.Locked-in syndrome after traumatic basilar artery entrapment within a clivus fracture: a case report and review of the literature. Neurotrauma Rep. 2020;1(1):73-77. doi:10.1089\/neur.2020.0015"},{"issue":"6","key":"bib14","series-title":"J Neurosurg","first-page":"588","article-title":"Incarceration of the basilar artery in a fracture of the clivus. Case report","volume":"28","author":"Sights","year":"1968","unstructured":"Sights WP.Incarceration of the basilar artery in a fracture of the clivus. Case report. J Neurosurg. 1968;28(6):588-591. doi:10.3171\/jns.1968.28.6.0588"}],"container-title":["Journal of Neurosurgery: Case Lessons"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-case-lessons\/12\/3\/article-CASE26393.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-case-lessons\/12\/3\/article-CASE26393.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-case-lessons\/12\/3\/article-CASE26393.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T00:01:16Z","timestamp":1784678476000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-case-lessons\/12\/3\/article-CASE26393.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,20]]},"references-count":14,"journal-issue":{"issue":"3"},"URL":"https:\/\/doi.org\/10.3171\/case26393","relation":{},"ISSN":["2694-1902"],"issn-type":[{"value":"2694-1902","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,20]]}}}