Background: Hemorrhage caused by the rupture of a rotundum foreman artery pseudoaneurysm in Moyamoya disease (MMD) is rarely reported.
Case description: We report a case of 46-year-old man with MMD presenting with left temporal lobe hemorrhage. Cerebral angiogram showed a pseudoaneurysm located on the rotundum branch of the left internal maxillary artery, which anastomosed with a pial vessel. Using onyx 18, we successfully embolized the pseudoaneurysm. The patient was discharged neurologically intact.
Conclusion: Given the difficulties and risks of surgery, onyx embolization of rotundum foreman artery aneurysm accompanied with MMD is feasible and effective.
Keywords: Aneurysm; Embolization; Moyamoya disease; Onyx; Rotundum foreman.
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