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 × 3.5 cm2 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 × 1.2 × 0.7 cm3
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: