Iatrogenic pseudoaneurysm of the superficial temporal artery following craniectomy from a scalp hook retractor penetrating injury: Case report and literature review

doi:10.1016/j.ijscr.2021.106076

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Title:	Iatrogenic pseudoaneurysm of the superficial temporal artery following craniectomy from a scalp hook retractor penetrating injury: Case report and literature review
Authors:	Zheng, Hong-Xiang Lee, Yao-Lin Chen, Guan-Yu Hung, Yi-Chieh
Contributors:	Chi Mei Med Ctr, Dept Neurosurg Chia Nan Univ Pharm & Sci, Dept Recreat & Healthcare Management
Keywords:	Pseudoaneurysm Superficial temporal artery Iatrogenic injury Craniectomy Fish hook retractor
Date:	2021
Issue Date:	2023-11-11 11:50:05 (UTC+8)
Publisher:	ELSEVIER SCI LTD
Abstract:	Background: Iatrogenic pseudoaneurysms in scalp vessels are an uncommon complication after cranial surgery. This paper reports a case of scalp pseudoaneurysm in the superficial temporal artery (STA) after forceful hook retraction in craniectomy and reviews the relevant literature. Case description: A 36-year-old man with history of hypertension and depression presented to the emergency department with head injury after using sedation medication. Brain computed tomography (CT) revealed a 2-cm-thick right parietal extradural hematoma (EDH) with parietal skull fracture, a bilateral lower frontotemporal contusional intracerebral hematoma, diffuse subarachnoid hemorrhage, and a right frontotemporoparietal subdural hematoma. To prevent EDH progression, frontotemporal emergency craniectomy to remove the EDH was performed. The next day, a firm, painful mass measuring 3 x 3.5 cm(2) was discovered over the right frontal scalp. The mass was close to the site where the scalp hook retractor had been placed during surgery. Sonography revealed pulsatile blood flow with an arterial feeder inside the mass. CT angiography revealed a 1 x 1.2 x 0.7 cm(3) pseudoaneurysm in the right frontal scalp from the frontal branch of the STA. We scheduled a resection of the pseudoaneurysm and combined cranioplasty on the 29th postoperative day. The pseudoaneurysm was resected en bloc. The patient was discharged with clear consciousness and intact muscle power. Conclusion: The complications of STA pseudoaneurysms caused by scalp hook retractors are rare and not yet well reported. Surgeons must avoid injuring the STA when using a scalp hook retractor.
Relation:	INT J SURG CASE REP, v.84, July 2021, 106076
Appears in Collections:	[Dept. of Recreation and Health-Care Management] Periodical Articles

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