Onyx Embolization of a Ruptured Rotundum Foreman Artery Aneurysm in a Patient with Moyamoya Disease: A Case Report

World Neurosurg. 2015 Oct;84(4):1178.e1-3. doi: 10.1016/j.wneu.2015.06.039. Epub 2015 Jun 25.


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.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aneurysm, Ruptured / etiology*
  • Aneurysm, Ruptured / therapy*
  • Cerebral Hemorrhage / etiology
  • Cerebral Hemorrhage / surgery
  • Drug Combinations
  • Embolization, Therapeutic / methods*
  • Female
  • Humans
  • Intracranial Aneurysm / etiology*
  • Intracranial Aneurysm / therapy*
  • Middle Aged
  • Moyamoya Disease / complications*
  • Moyamoya Disease / therapy
  • Polyvinyls*
  • Tantalum*
  • Treatment Outcome


  • Drug Combinations
  • Onyx 18
  • Polyvinyls
  • Tantalum