The use of a balloon guide catheter (BGC) in the endovascular management of acute ischemic stroke is known to improve the efficacy and efficiency of the procedure by reducing the risk of distal embolization. During the procedure, the balloon of the catheter causes a temporary arrest of cerebral blood flow. However, failure of the balloon to deflate during the BGC procedure can result in catastrophic complications, including aggravated hypoxic damage.
This paper aims to share the resolution and methodological analysis of our experience with BGC balloon deflation failure, which was confirmed by a reproducible experiment under similar conditions.

Progressive epidural hematoma is a form of acute epidural hematoma that graduallyexpands from a small initial hematoma; in cases that are clinically aggravated dueto the presence of a mental illness or neurological condition, patients should be surgicallytreated for evacuation of the hematoma, but poorer outcomes are expected ifthe patient has several medical co-morbidities for surgery. We experienced two casesof progressive epidural hematoma which were successfully managed by endovasculartreatment: an 85-year-old male with medical co-morbidities and a 51-year-oldfemale with a poor-grade subarachnoid hemorrhage resulting from the rupture of adissecting aneurysm of the vertebral artery. In both cases, a middle meningeal arteryembolization was performed and contrast leakage was observed and controlled usingcerebral angiography, halting the progression of their epidural hematomas. Thus,endovascular embolization of a middle meningeal artery may play a useful role in salvagetherapy in certain complicated situations that limit treatment of the hematomaby surgical evacuation.