Pseudoaneurysm of the Superficial Temporal Artery Following Craniotomy. Case Report.

Abstract

A 48-year-old male without marked blood coagulation disorder developed a pseudoaneurysm of the superficial temporal artery (STA) following craniotomy. Cerebral angiography revealed a pseudoaneurysm on the parietal branch of the STA. Total extirpation was performed, and the postoperative course was uneventful. Most pseudoaneurysms of the STA develop after trauma. Lesions rarely develop after craniotomy. However, pseudoaneurysm of the STA should be considered as a possible surgical complication.

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).…”

“…A STA pseudoaneurysm mostly presents as a mass lesion in the territory with a history of trauma (15). These masses can be painful (11), "uncomfortable" (16), indolent (25), pulsatile (13,18,26), enlarging (14), tender (2,13), non-tender (26) rubbery (1), erythematous (2) or without any cutaneous erythema (12) and bruit can be appreciable on auscultation (18). A pulsating mass that is easily compressible with digital pressure and bruit on auscultation are very discriminating features (13,18).…”

“…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.…”

“…They can emerge either spontaneously (17,20), or as a complication of trauma (13,16), interventions (1,9) and injections (19). Pseudoaneurysms are rare complications of craniotomies (2,7,12, [21][22][23][24][25][26]. In this report, 59-year-old woman with a pseudoaneurysm of STA which developed following a revision surgery is presented.…”