PMC4722520_01
Preoperative computed tomography, axial view, showing left-sided temporal intracerebral hemorrhage, right subdural hematoma
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F1
IPH measuring 8 cm by 2 cm by 1.5 cm [Figure 1]. In addition, there was a left-sided temporal bone fracture.
Preoperative computed tomography angiogram, coronal reconstruction, demonstrating a left temporal skull fracture (a and b) with a left middle meningeal artery pseudoaneurysm (a, arrow)
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F2
The CTA demonstrated some dilatation of the left MMA suspicious for a pseudoaneurysm near the fracture site [Figure 2].
Cerebral angiogram, lateral view of external carotid artery injection, showing left middle meningeal artery pseudoaneurysm with an irregular neck (arrow)
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A six-vessel cerebral angiogram was performed on the postoperative day 1 [Figure 3], which confirmed the presence of a traumatic pseudoaneurysm of the left MMA, which was treated with Onyx  embolization.
Three-month postembolization angiogram demonstrating complete obliteration of the pseudoaneurysm and middle meningeal artery both in a lateral view (a) and an anterior-posterior view (b)
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The patient had an uncomplicated cranioplasty at 3 months, and an angiogram confirmed obliteration of the left MMA [Figure 4], without recurrence of her pseudoaneurysm at 3 months.