title: Computed tomography angiography for detection of middle meningeal artery lesions associated with acute epidural hematomas.
abstract: BACKGROUND
  The natural history of traumatic aneurysms of the middle meningeal artery (MMA) is not well known, but patients with these lesions are more likely to have delayed bleeds. In this paper, we described a series of patients with epidural hematoma who underwent angiotomography (CTA) for MMA vascular lesion diagnosis.
  
  
  METHODS
  Eleven patients admitted to our emergency unit with small acute epidural hematoma were prospectively studied. All patients with temporal acute epidural hematomas underwent CTA and cerebral angiogram at our institution for diagnosis of posttraumatic lesions of middle meningeal artery. The findings of angiotomography and digital angiography were reviewed by radiologist and angiographers, respectively, to ensure that the lesions were readily diagnosed without knowing the results of angiotomography and to compare CTA findings with standard angiogram.
  
  
  RESULTS
  The causes of head injury were traffic accidents, falls, and aggression. Three of these patients presented traumatic MMA pseudoaneurysm. CT angiography was able to diagnose all of them, with dimensions ranging from 1.5 to 2.8 mm. Conventional angiography confirmed the findings of CT angiography, and the lesions presented with similar dimensions at both methods.
  
  
  CONCLUSIONS
  We believe that angiotomography can be a useful technique for diagnosis of vascular lesion associated with small epidural hematoma.
authors.affiliation: Division of Neurological Surgery, University of Sao Paulo Medical School, 255 Eneas Aguiar Street, Office 4080, 05403010 Sao Paulo, SP, Brazil.
authors.forename: Wellingson Silva
authors.initials: WS
authors.lastname: Paiva
authors.affiliation: Division of Neurological Surgery, University of Sao Paulo Medical School, 255 Eneas Aguiar Street, Office 4080, 05403010 Sao Paulo, SP, Brazil.
authors.forename: Almir Ferreira
authors.initials: AF
authors.lastname: Andrade
authors.affiliation: Division of Neurological Surgery, University of Sao Paulo Medical School, 255 Eneas Aguiar Street, Office 4080, 05403010 Sao Paulo, SP, Brazil.
authors.forename: Robson Luis Oliveira De
authors.initials: RL
authors.lastname: Amorim
authors.affiliation: Division of Neurological Surgery, University of Sao Paulo Medical School, 255 Eneas Aguiar Street, Office 4080, 05403010 Sao Paulo, SP, Brazil.
authors.forename: Edson
authors.initials: E
authors.lastname: Bor-Seng-Shu
authors.affiliation: Institute of Radiology, University of Sao Paulo Medical School, 470 Alves Guimaraes Street, 05410-000 Sao Paulo, SP, Brazil.
authors.forename: Gabriel
authors.initials: G
authors.lastname: Gattas
authors.affiliation: Division of Neurological Surgery, University of Sao Paulo Medical School, 255 Eneas Aguiar Street, Office 4080, 05403010 Sao Paulo, SP, Brazil.
authors.forename: Iuri Santana
authors.initials: IS
authors.lastname: Neville
authors.affiliation: Institute of Radiology, University of Sao Paulo Medical School, 470 Alves Guimaraes Street, 05410-000 Sao Paulo, SP, Brazil.
authors.forename: Jose Guilherme
authors.initials: JG
authors.lastname: Caldas
authors.affiliation: Division of Neurological Surgery, University of Sao Paulo Medical School, 255 Eneas Aguiar Street, Office 4080, 05403010 Sao Paulo, SP, Brazil.
authors.forename: Eberval Gadelha
authors.initials: EG
authors.lastname: Figueiredo
authors.affiliation: Division of Neurological Surgery, University of Sao Paulo Medical School, 255 Eneas Aguiar Street, Office 4080, 05403010 Sao Paulo, SP, Brazil.
authors.forename: Manoel Jacobsen
authors.initials: MJ
authors.lastname: Teixeira
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D002533:Cerebral Angiography / Q000379:methods*; D006259:Craniocerebral Trauma / Q000000981:diagnostic imaging*; D005260:Female; D006407:Hematoma, Epidural, Cranial / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008576:Meningeal Arteries / Q000000981:diagnostic imaging*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*; D055815:Young Adult