Ruptured pseudoaneurysm of the superficial temporal artery after craniotomy

Honda, Masaru; Anda, Takeo; Ishihara, Tokuhiro

doi:10.4103/0028-3886.125406

Cited by 7 publications

(12 citation statements)

References 6 publications

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“…The time period from craniotomy to pseudoaneurysm in the literature varied between 4 days and 3 months ( 7 ), and in our case it was 1 month post-operatively. The typical history involves trauma or surgery to the temporal region ( 5 , 7 ) and subsequent development of a pulsatile, indolent or expanding swelling which may be associated with headache ( 4 , 7 ). Other neurologic symptoms are not always present but may include facial pain, dizziness, ear discomfort, or facial droop due to cranial nerve VII compression ( 1 ).…”

Section: Discussionmentioning

confidence: 66%

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Superficial Temporal Artery Pseudoaneurysm: A Case Report

2015

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Pseudoaneurysms of the superficial temporal artery are an uncommon vascular lesion of the external carotid system and most often the result of blunt head trauma. The frequency of pseudoaneurysms of the superficial temporal artery developing after craniotomy is exceedingly low and only a few cases have been reported. We present a case of pseudoaneurysm of this type in a 45-year-old male who underwent craniotomy for excision of meningioma. One month postoperatively, the craniotomy flap exhibited an enormous diffuse pulsate swelling. The suspected diagnosis of pseudoaneurysm arising from superficial temporal artery was confirmed on angiography. Surgical excision was done and no recurrences of the tumor or aneurysm were noted on subsequent follow up.

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Section: Discussionmentioning

confidence: 66%

“…In some cases, pulsation may be absent if there is complete thrombosis of the aneurysmal sac ( 10 ). On examination, a compressible, tender, pulsatile mass over the superior temporal line is usually apparent and occasionally bruits may be ausculatated ( 1 , 5 , 7 ).…”

Section: Discussionmentioning

confidence: 99%

Superficial Temporal Artery Pseudoaneurysm: A Case Report

2015

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“…Previous reports suggested that iatrogenic pseudoaneurysms at the STA or OA result in poor outcomes due to marked hemorrhage. [6][7][8] Therefore, pseudoaneurysms on the scalp should be managed promptly. [6][7][8] As they are located on the superficial region of the scalp, they can be diagnosed by ultrasonography 9,10) or surgical resection under local anesthesia as diagnostic treatment.…”

Section: Discussionmentioning

confidence: 99%

“…[6][7][8] Therefore, pseudoaneurysms on the scalp should be managed promptly. [6][7][8] As they are located on the superficial region of the scalp, they can be diagnosed by ultrasonography 9,10) or surgical resection under local anesthesia as diagnostic treatment. 2) On the other hand, pseudoaneurysms at the DTA are located in an anatomically deeper layer, and standard ultrasonography and/or direct surgical exploration may fail to detect them.…”

Section: Discussionmentioning

confidence: 99%

Iatrogenic Pseudoaneurysm at the Deep Temporal Artery after Fronto-temporal Craniotomy Manifesting as Repeated Subcutaneous Hemorrhage -Case Report-

Katsuki

Fujimura

Sato

et al. 2020

NMC Case Report Journal

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Iatrogenic pseudoaneurysm formation at the deep temporal artery (DTA) is a rare complication after neurosurgical intervention by craniotomy, and its management strategy has yet to be determined. We report a patient who developed iatrogenic pseudoaneurysm at the DTA after fronto-temporal craniotomy manifesting as repeated subcutaneous hemorrhage. A 44-year-old man underwent standard fronto-temporal craniotomy for the microsurgical clipping of a ruptured anterior communicating artery aneurysm in the acute stage. The initial postoperative course was uneventful, but he developed a massive subcutaneous hematoma that penetrated the surgical wound, leading to hypovolemic shock 23 days after the aneurysm surgery. Due to the continuous hemorrhage after temporary hemostasis by ligation of the superficial temporal artery, he underwent catheter angiography, which revealed a newly-formed pseudoaneurysm at the DTA that was 16 mm in diameter. Neuroendovascular obliteration of the pseudoaneurysm was successfully performed using liquid embolization material, n-butyl-2-cyanoacrylate, under local anesthesia. Pseudoaneurysm at the DTA is a rare but possible complication after fronto-temporal craniotomy, which can be fatal due to marked hemorrhage. Due to the anatomically deep location of the DTA under the temporal muscle, we recommend accurate diagnosis of the pseudoaneurysm by catheter angiography and prompt obliteration of the affected vessel by a neuroendovascular procedure under local anesthesia, especially when the hemodynamic status is unstable.

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“…The rupture of the aneurysmal sac can lead to heavy bleeding, which can be life-threatening. 26 Despite this, there is a relative lack of information on this topic, the consequences of which can be fatal. With the advancement of diagnostic imaging techniques and their availability in most of the main centers of trauma care, the surgeon should be aware of the methods for proper diagnosis of this type of lesion and also be prepared to deal with it.…”

Section: Introductionmentioning

confidence: 96%