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后颅窝开颅术后枕动脉假性动脉瘤

Occipital Artery Pseudoaneurysm After Posterior Fossa Craniotomy.

作者信息

Srinivasan Visish M, Karas Patrick J, Sen Anish N, Fridley Jared S, Chen Stephen R, Gopinath Shankar P

机构信息

Department of Neurosurgery, Baylor College of Medicine, Houston, Texas, USA.

Department of Radiology, Baylor College of Medicine, Houston, Texas, USA.

出版信息

World Neurosurg. 2017 Feb;98:868.e1-868.e4. doi: 10.1016/j.wneu.2016.12.050. Epub 2016 Dec 23.

Abstract

BACKGROUND

Pseudoaneurysms of scalp arteries have been reported in rare cases after iatrogenic injury; however, they are far more commonly seen after traumatic injuries. They are usually associated with the superficial temporal artery; however, there have been a few reports of psuedoaneurysms of the occipital artery (OA).

CASE DESCRIPTION

We present a unique case of an OA pseudoaneurysm presenting with delayed postoperative hemorrhage after a retrosigmoid craniotomy. The pseudoaneurysm was treated by coil embolization.

CONCLUSIONS

The patient recovered fully after endovascular embolization. Other treatment options for pseudoaneurysms of facial, temporal, and scalp arteries include surgical clipping/trapping with excision, Hunterian ligation, or direct compression. Pseudoaneurysms of extracranial scalp arteries are rare and most often caused by traumatic compression of the artery against a bony ridge. Despite their rarity, pseudoaneurysms secondary to iatrogenic injury to extracranial arteries should be considered in the differential diagnosis in patients presenting with delayed incisional pain, redness, and swelling.

摘要

背景

医源性损伤后罕见报道头皮动脉假性动脉瘤;然而,其在创伤性损伤后更为常见。它们通常与颞浅动脉相关;不过,也有少数枕动脉(OA)假性动脉瘤的报道。

病例描述

我们呈现了1例独特的枕动脉假性动脉瘤病例,该病例在乙状窦后开颅术后出现延迟性术后出血。该假性动脉瘤通过弹簧圈栓塞治疗。

结论

患者在血管内栓塞后完全康复。面部、颞部和头皮动脉假性动脉瘤的其他治疗选择包括手术夹闭/切除并结扎、亨特氏结扎或直接压迫。颅外头皮动脉假性动脉瘤罕见,最常见的原因是动脉受骨性嵴挤压。尽管罕见,但对于出现切口延迟性疼痛、发红和肿胀的患者,在鉴别诊断时应考虑医源性损伤导致的颅外动脉假性动脉瘤。

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