[Subarachnoid hemorrhage and intracerebral hematoma in injury of the middle meningeal artery (aneurysma spurium)].

Traumatic lesions of meningeal arteries represent the typical cause of the acute epidural hematoma. Under certain circumstances, however, they may be the origin of space-occupying hemorrhages with only an intradural extent, e.g. subdural or intracerebral hematomas. We present a case of a temporal lobe hematoma with an additional subarachnoid hemorrhage. This gave rise to the suspicion of a spontaneously ruptured cerebral aneurysm that might have caused the patient's accident. Preceding the evacuation of the hematoma, cerebral angiography ruled out the suspected vascular malformation, but revealed a pseudoaneurysm of the middle meningeal artery close to a skull fracture. Intraoperatively, this lesion proved to be the source of the bleeding which was exclusively directed towards the intradural space. Presented is a review of the relevant literature regarding atypical hematomas secondary to meningeal artery lesions and traumatic aneurysms of these vessels.