Hasegawa Hiroshi, Tsutsumi Satoshi, Yasumoto Yukimasa, Inaba Toshihisa, Ito Masanori
Department of Neurological Surgery, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu, Chiba, 279-0021, Japan.
Childs Nerv Syst. 2011 Jun;27(6):1011-4. doi: 10.1007/s00381-010-1384-7. Epub 2011 Mar 2.
Pseudoaneurysm arising from the superficial temporal artery (STA) is an uncommon sequela of head and facial trauma. This entity is very rare in the pediatric population. The conventional treatment is surgical excision.
A 13-month-old boy presented with a progressively enlarging subcutaneous mass in the left forehead that appeared 1 week after indoor minor head trauma. The mass was hard and prominently expansile and was more than 5 cm in the largest dimension. The mass did not have audible bruit and was not diminished by manual compression of the proximal STA. Cranial computed tomography (CT) did not reveal intracranial hemorrhage or skull fracture in association with the head trauma. CT angiography showed a large aneurysm arising from the anterior branch of the left STA.
En bloc extirpation of the aneurysm was performed. Histological examination of the excised specimen showed findings consistent with pseudoaneurysm.
In addition to careful observation for a sufficiently long period after the head trauma, neurosurgeons should be aware of the need to start treatment before a traumatic pseudoaneurysm reaches a significant size.
颞浅动脉(STA)假性动脉瘤是头面部创伤后不常见的后遗症。该病症在儿科人群中极为罕见。传统治疗方法是手术切除。
一名13个月大的男孩,在室内轻微头部创伤1周后,左前额出现一个逐渐增大的皮下肿块。肿块质地坚硬,有明显的扩张性,最大直径超过5厘米。肿块无明显可闻及的杂音,近端颞浅动脉手动压迫时肿块大小无减小。头颅计算机断层扫描(CT)未发现与头部创伤相关的颅内出血或颅骨骨折。CT血管造影显示左颞浅动脉前支出现一个大动脉瘤。
对动脉瘤进行了整块切除。切除标本的组织学检查结果与假性动脉瘤一致。
除了在头部创伤后进行足够长时间的仔细观察外,神经外科医生还应意识到在创伤性假性动脉瘤达到较大尺寸之前就开始治疗的必要性。