Superficial temporal artery pseudoaneurysm presenting as extradural hematoma: A case report and review of literature

Madhusudan, Hassan Vijayendra; Krishnamoorthy, Naveen; Suresh, Praveen Karenahalli; Subramaniam, Venugopal

doi:10.4103/1793-5482.154870

Cited by 9 publications

(15 citation statements)

References 11 publications

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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%

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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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Section: Discussionmentioning

confidence: 99%

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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show abstract

“…The majority of pseudoaneurysms present themselves as asymptomatic pulsatile masses, although focal symptoms and dizziness are also reported. Madhusudan et al 5 reported an extradural hematoma case after a ruptured STA pseudoaneurysm, causing extensive symptomatology, as paresis and dysphasia. Although they may range 0.5-5.7 cm in diameter, most are between 1-1.5 cm 6 .…”

Section: Introduction Case Presentation O Conhecimento Dessa Condição é Importante Para O Diagnóstico Etiológico De Uma Cefaleia Temporalmentioning

confidence: 99%

“…Madhusudan et al 5 reported an extradural hematoma case after a ruptured STA pseudoaneurysm, causing extensive symptomatology, as paresis and dysphasia.…”

Section: Introduction Case Presentation O Conhecimento Dessa Condição é Importante Para O Diagnóstico Etiológico De Uma Cefaleia Temporalmentioning

confidence: 99%

Superficial temporal artery pseudoaneurysm as cause of refractory headache

Cavalcante-Neto¹,

Oliveira²,

Esmeraldo³

et al. 2021

jbnc

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Case presentation: A 36-year-old male presented with moderate, progressive headache, in the left temporal region, irradiating to the ipsilateral frontal region, with several months of evolution, refractory to analgesic medication, including opioids. He reported a closed traumatic brain injury (TBI) 5 years before in a motorcycle collision with an automobile, without a helmet. At the physical examination, it was possible to verify a pulsatile mass measuring 1.5 cm in diameter, with fremitus, in the left temporal region. The magnetic resonance imaging scan presented a round lesion, encapsulated, on the course of the superficial temporal artery (STA). The digital subtraction angiography confirmed the diagnosis of STA pseudoaneurysm. A surgical resection of the aneurysm was performed, leading to the complete resolution of the headache. Discussion: The STA pseudoaneurysm is a rare condition, representing less than 1% of aneurysms, usually presenting as a late complication of TBI. The majority of cases are asymptomatic, although focal symptoms and even bleeding may occur. The presentation with a chronic refractory headache is exceptional. Its treatment is indicated for local symptom resolution, aesthetic purposes, and rupture prevention, done by clipping and resection of the pseudoaneurysm. Conclusion: Even though unusual, the awareness of this condition is important for the etiological diagnosis of a persistent temporal headache in a patient with a history of TBI.

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“…[2][3][4][5][6] The rich historical etiology of STAP and its potential for significant bleeding should the diagnosis be overlooked make discussion of this condition worthwhile. 7 Here we present two cases of aneurysmal dilatation from two separate institutions which resulted in two different approaches to management and a comprehensive review of the literature.…”

mentioning

confidence: 99%

Pseudoaneurysm of the Superficial Temporal Artery—Two Case Reports of a Rare Entity

Jedrzejewski

Annen

Berli

et al. 2018

Craniomaxillofacial Trauma & Reconstruction Open

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In this paper, the authors present two case reports with patients who presented at different institutions for traumatic aneurysmal dilation of temporal vessels. The first case is a 18-year-old male who presented to plastic surgery following attempted excision by an outside provider after a fist fight. The second case is a 22-year-old male who presented to plastic surgery while inpatient after gunshot wound to the face. The differences in the cases are highlighted by the different approaches to the management of the lesions with direct incision and embolization respectively.

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Superficial temporal artery pseudoaneurysm presenting as extradural hematoma: A case report and review of literature

Cited by 9 publications

References 11 publications

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

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

Superficial temporal artery pseudoaneurysm as cause of refractory headache

Pseudoaneurysm of the Superficial Temporal Artery—Two Case Reports of a Rare Entity

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