Tear of the Middle Meningeal Artery

Middle aged man involved in a head-on MVA. An epidural hematoma was noted over the left frontal area on CT. An angiogram was requested by the trauma service to assess for an arterial bleed.

Unsubtracted and subtracted views in the frontal projection of a left external carotid artery injection.  At the level of the cranial base, the middle meningeal artery has torn secondary to a skull base fracture. Extravasation of contrast from the damaged artery is demonstrated.

 

Subtracted and unsubtracted views in the lateral projection also demonstrate the
extravasation from the torn middle meningeal artery.

Angiogram in the lateral view post-embolization with polyvinyl alcohol particles.