Traumatic pseudoaneurysms of the head and neck: Early endovascular intervention

Cox, Margueritte; Whittaker, David R.; Martinez, C.M.; Fox, Charles J.; Feuerstein, Irwin M.; Gillespie, David L.

doi:10.1016/j.jvs.2007.08.021

Cited by 108 publications

(91 citation statements)

References 15 publications

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“…Posttraumatic pseudoaneurysms can present as pulsatile scalp mass but it is important to emphasise that such presentation, i.e. massive or minor bleeding, or sudden-onset neck swelling, did not exist in our case [8]. The differential diagnosis should include dermoid or epidermoid cyst, eosinophilic granuloma, hematoma, abscess, aneurysm, arteriovenous fistula, encephalocele, lymphoid hyperplasia and sinus pericranii [9].…”

Section: Case Reportmentioning

confidence: 85%

“…Blunt force is the cause attributed in most cases where the small amount of underlying muscle tissue does not provide enough cushioning between vessel and bone [7]. It is also important to emphasise highexplosive military munitions used on battlefields which produce a variety of devastating injuries and are only rarely seen in civilian practices [8].…”

Section: Case Reportmentioning

confidence: 99%

“…Treatment options for traumatic pseudoaneurysms include simple resection of the aneurysm, coil embolization [11] and direct thrombin injection [12], proximal ligation of parent artery or trapping of the aneurysm [13]. However, an open approach to many of these lesions may be fraught with peril due to grossly distorted and oedematous tissue planes that often have heavy bacterial colonisation [8]. In most cases, the use of endovascular techniques offers the most straightforward and low risk treatment option.…”

Section: Case Reportmentioning

confidence: 99%

“…In most cases, the use of endovascular techniques offers the most straightforward and low risk treatment option. Embolization of external carotid lesions, in particular, is a simple and effective procedure which eliminates the risk of delayed bleeding [8]. Aneurysms can be treated prophylactically when the patient is liable to experience further trauma, or when it may cause cosmetic problems.…”

Section: Case Reportmentioning

confidence: 99%

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Unusual Presentation of Traumatic Pseudoaneurysm of the Posterior Auricular Artery Manifesting by Massive Bleeding from the External Auditory Canal: A Case Report

Sokół¹,

Stanisławska²,

Jankowski³

et al. 2017

J Clin Case Rep

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Section: Case Reportmentioning

confidence: 85%

Section: Case Reportmentioning

confidence: 99%

Section: Case Reportmentioning

confidence: 99%

Section: Case Reportmentioning

confidence: 99%

See 2 more Smart Citations

Unusual Presentation of Traumatic Pseudoaneurysm of the Posterior Auricular Artery Manifesting by Massive Bleeding from the External Auditory Canal: A Case Report

Sokół¹,

Stanisławska²,

Jankowski³

et al. 2017

J Clin Case Rep

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“…The diagnosis of these vascular complications is made easy with the availability of CT angiography [1,2]. A CT scan also is advantageous in assessing the artery of origin and relation of the pseudoaneurysm with the bony fractures and planning the treatment strategy.…”

Section: Discussionmentioning

confidence: 99%

Traumatic Internal Maxillary Artery Pseudoaneurysm with a Malunited Mandibular Fracture

Thakkur

Kapadia

Merchant

2011

J. Maxillofac. Oral Surg.

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Post-traumatic external carotid artery pseudoaneurysms are very uncommonly encountered in clinical practice. We present the case of a young man who developed pseudoaneurysm 5 weeks after a maxillofacial injury treated elsewhere. Case PresentationA 23-year-old male presented with a history of swelling over the left side of face since 1 week. He had a history of road traffic accident 5 weeks ago. He was treated elsewhere after the injury by tracheostomy, open reduction and internal fixation of his mandibular symphysis fracture with closed approach for his condylar head fractures. On examination, the patient had left sided facial palsy, tender diffuse swelling over left side of face and neck, trismus and dental malocclusion. A computed tomography (CT) scan with angiography was performed which revealed a pseudoaneurysm of the terminal branch of external carotid artery about 6.6 9 4.9 9 8.9 cm in diameter AP/RL/CC (Fig. 1). Bilateral sagitally fractured condylar heads and left coronoid process fractures were noted with lateral flaring of the left mandible. Symphysis was fixed using plates and screws (Fig. 2). The radiologist interpreted on CT scan that the origin of the pseudoaneurysm was most likely to be the superficial temporal artery.The treatment plan was surgical repair of the superficial temporal artery pseudoaneurysm and correction of the malocclusion by mandibular repositioning. A preauricular incision was made, the pseudoaneurysm identified and the superficial temporal artery was doubly ligated. On opening the pseudoaneurysm wall, to our surprise, there was a torrential bleed from within, thus raising the possibility of another source of the pseudoaneurysm origin. With pressure applied locally, an extension of the incision in the neck to a parotidectomy type was made. The external carotid artery (ECA) was identified and a vascular control sought. ECA control was then tightened to minimize the bleeding and 5-0 polypropylene (Prolene, Ethicon) was used to suture repair the rent in distal part of internal maxillary artery from within the pseudoaneurysm cavity. Hemostasis was confirmed after releasing the ECA. The symphyseal fracture was re-osteotomized using an existing chin scar, and the entire left mandible mobilized medially at the ramal angle to correct the flaring, two 2.5 mm miniplates were secured with eight screws at the symphysis. A satisfactory neoocclusion was achieved. A suction drain was applied and closure was done in layers. The post-operative course was uneventful (Fig. 3). DiscussionIn the head and neck, blunt, penetrating or surgical trauma can infrequently lead to damage of vessels resulting in pseudoaneurysms. The diagnosis of these vascular complications is made easy with the availability of CT angiography [1,2]. A CT scan also is advantageous in assessing the artery of origin and relation of the pseudoaneurysm with the bony fractures and planning the treatment strategy. In our patient depending on the CT angiography, we however misinterpreted the pseudoaneurysm in the pre-auricul...

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Posttraumatic Lingual Artery Pseudoaneurysm and Synchronous Multiple Pneumatosis in a Child

Touli

Kechagia

Batziou

et al. 2022

JAMA Otolaryngol Head Neck Surg

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Traumatic pseudoaneurysms of the head and neck: Early endovascular intervention

Cited by 108 publications

References 15 publications

Unusual Presentation of Traumatic Pseudoaneurysm of the Posterior Auricular Artery Manifesting by Massive Bleeding from the External Auditory Canal: A Case Report

Unusual Presentation of Traumatic Pseudoaneurysm of the Posterior Auricular Artery Manifesting by Massive Bleeding from the External Auditory Canal: A Case Report

Traumatic Internal Maxillary Artery Pseudoaneurysm with a Malunited Mandibular Fracture

Posttraumatic Lingual Artery Pseudoaneurysm and Synchronous Multiple Pneumatosis in a Child

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