Intraorbital False (Thrombosed) Aneurysm of the Meningolacrimal Branch of the Middle Meningeal Artery: A Case Report and an Appraisal of Anatomy

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Purpose:To describe a rare case of a thrombosed (false) aneurysm of the meningolacrimal branch of the middle meningeal artery.Methods:Interventional case report.Results:A 36-year-old man presented with unilateral proptosis of sudden onset after minor head trauma. Imaging showed an apical oval mass interposed between the superior and lateral rectii muscles in close proximity to a vessel about 0.5 mm in diameter. On carotid angiography, the mass did not fill with contrast material, but the adjacent artery proved to be the meningolacrimal branch of the middle meningeal artery. This pseudoaneurysm was successfully evacuated surgically, and the overlying vessel was ligated.Conclusion:Orbital aneurysms are exceedingly rare and almost exclusively derived from the ophthalmic artery. To the best of our knowledge, this is the first reported case of an intraorbital aneurysm arising from the meningolacrimal branch of the middle meningeal artery which was successfully managed surgically.

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