Pan James, Barros Guilherme, Greil Madeline E, Meyer R Michael, Ene Chibawanye I, Chesnut Randall M
Department of Neurological Surgery, University of Washington, Seattle, Washington.
Oper Neurosurg. 2020 Sep 1;19(3):288-291. doi: 10.1093/ons/opaa151.
Pseudoaneurysms involving the superficial temporal artery (STA), either iatrogenic or caused by direct trauma, are rare. The STA is prone to injury due to its long course throughout the scalp. Injuries can cause cosmetic defects and/or skin breakdown leading to further complications.
We report a case of delayed iatrogenic pseudoaneurysm of the STA after placement of an intracranial pressure monitor in the setting of acute traumatic brain injury. The patient had a delayed development of a pulsatile mass over his right frontal region, with computed tomography angiography concerning for a pseudoaneurysm of the STA. This was managed with surgical resection with complete resolution of symptoms at follow-up.
We review the literature regarding the etiology, pathogenesis, and management of these lesions. While iatrogenic injuries to the STA have been previously reported, this is a curious case related to placement of an intracranial pressure monitor. We recommend direct surgical resection of the pseudoaneurysm for cosmetic effect and prevention of further wound breakdown.
涉及颞浅动脉（STA）的假性动脉瘤，无论是医源性的还是由直接创伤引起的，都很罕见。颞浅动脉因其在头皮内走行较长，容易受到损伤。损伤可导致美容缺陷和/或皮肤破损，进而引发更多并发症。
我们报告一例急性创伤性脑损伤患者在放置颅内压监测器后发生的医源性STA延迟性假性动脉瘤病例。患者右额部出现搏动性肿块，且延迟出现，计算机断层血管造影显示为STA假性动脉瘤。通过手术切除进行治疗，随访时症状完全缓解。
我们回顾了关于这些病变的病因、发病机制和治疗的文献。虽然此前已有医源性STA损伤的报道，但这是一例与放置颅内压监测器相关的特殊病例。我们建议直接手术切除假性动脉瘤，以达到美容效果并防止伤口进一步破溃。
