Hematoma caused by rupture of a pseudoaneurysm in the middle meningeal artery (MMA) after trauma usually present with epidural hematoma. Intracerebral hemorrhage (ICH) is extremely rare. We reviewed ICH due to rupture of MMA pseudoaneurysm. We found that in cases of acute ICH, a pseudoaneurysm was attached to the outer surface of the dura mater and associated with dura tear. In patients with acute ICH, intraoperative rupture of pseudoaneurysm developed just after bone flap removal. In cases of delayed ICH, pseudoaneurysms adhered to the inner surface of the dura mater. In patients with delayed ICH, intraoperative rupture of pseudoaneurysm developed during dura opening and hematoma removal. In situations of dura tear after trauma, rupture of pseudoaneurysms might lead to ICH via a dura tear. Pseudoaneurysms that develop in the MMA after trauma may exert pressure on and result in the thinning of the dura mater. In this case, pseudoaneurysms will adhere to the inner surface of the dura mater after several days or weeks. ICH might develop through both acute and delayed mechanisms following development of pseudoaneurysms in the MMA. Clinicians should pay attention to the timing of such ruptures during operations for both acute and delayed ICH.

Bloodstream infection (BSI) after pediatric liver transplantation (PLT) is a common and severe complication that affects patient survival. Children with biliary atresia (BA) are at an increased risk for clinically significant infections. This study evaluated the impact of post-PLT BSI on clinical outcomes in children with BA. A total of 67 patients with BA aged <18 years who underwent PLT between April 2006 and September 2020 were analyzed and divided into two groups according to the occurrence of post-PLT BSI within 1 month (BSI vs. no BSI = 13 [19.4%] vs. 54 [80.6%]). The BSI group was significantly younger at the time of PLT and had a higher frequency of BSI at the time of PLT than the no BSI group. Early vascular complications within 3 months and reoperations were significantly more frequent in the BSI group. Univariate and multivariate analyses revealed that bacteremia within 1 month of PLT and graft-to-recipient weight ratio >4% were significantly associated with vascular complications. In conclusion, BSI after PLT is associated with increased vascular complications and reoperations. Proper control of bacterial infections and early liver transplantation before uncontrolled BSI may reduce vascular complications and unexpected reoperations in children with BA.