Postoperative pseudoaneurysm of the superficial temporal artery (S.T.A.) treated with Thrombostat� (thrombin glue) injection

Abstract

The pulsating mass proved to be a postoperative aneurysm of the superficial temporal artery (S.T.A.) and was successfully occluded with 500 units Thrombostat (thrombin glue) which was injected into the aneurysm sac using a 22-gauge needle guided by ultrasound. The permanency of the obliteration was verified by ultrasound examination.

Degenerative (True) Superficial Temporal Artery Aneurysm: A Case Report With Review of Literature

“…Thrombin injection has also been reported with success and may be considered an alternative treatment in the very-high-risk patients. [26][27][28] In conclusion, aneurysms of STA are most commonly secondary to trauma. However, radiological imaging is needed to rule out intracranial extension or an alternative diagnosis.…”

Pseudoaneurysm of the superficial temporal artery following revision of a middle cerebral artery aneurysm clipping: case report and review of the literature.

“…These operations can be non-neurosurgical per se, like reconstruction of the frontal sinus via a coronal flap (15), temporomandibular arthroplasty (6) and skin graft coverage (9). Placement of external ventricular drainage (1), removal of a tumor (21), of a hematoma (23,23) and clipping of an intracranial aneurysm (2,7,12,25,26) are examples of neurosurgical procedures causing pseudoaneurysms of STA. However, a pseudoaneurysm formation following a revision craniotomy has not been reported before (Table I).…”

“…Imaging studies for accurate diagnosis of STA pseudoaneurysm can be either invasive or noninvasive; sonography (2,3), contrast enhanced CT scanning (11,16), CT angiography (10,11,16,26), 3-dimensional CT angiography (18) and selective angiography (2,11,25) are the most commonly used techniques. The differential diagnosis of STA pseudoaneurysms include abscess, hematoma, inflammatory lesion, parotid mass, lipoma, epidermal inclusion cyst, enlarged lymph node, a tumor of facial nerve, arteriovenous malformation or fistula and middle meningeal artery aneurysm with bony erosion (1,11,13,26).…”

“…The pseudoaneurysms of the STA should be treated in order to reduce the risk of rupture and hemorrhage, treatment of headache, resolving the cosmetic defect and reducing long term risk of potential bony erosion and recurrence by reaching enormous dimensions (2,10,11,13,16,25). It may also cause seizures and ischemia in the scalp.…”

Pseudo-aneurisma traumático gigante da artéria temporal superficial: Relato de caso com 11 anos de evolução

“…A compressão manual repetida, embora descrita por alguns autores, freqüentemente é ineficaz 17 . A embolização via endovascular 8,13 e a trombose induzida por injeção percutânea de cola de trombina 3 foram descritas, porém são restritas a pequenas lesões e não aliviam o efeito de massa. O método de escolha, particularmente nas grandes tumorações, é a excisão cirúrgica após ligadura proximal e distal da artéria temporal superficial 17 .…”