Occipital Artery Pseudoaneurysm After Posterior Fossa Craniotomy

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.

Keywords: Aneurysm; Coiling; Craniotomy; Embolization; Endovascular; Pseudoaneurysm; Trauma.

Publication types

  • Case Reports

MeSH terms

  • Aneurysm, False / etiology*
  • Aneurysm, False / surgery
  • Cerebral Arterial Diseases / etiology*
  • Cerebral Arterial Diseases / surgery
  • Craniotomy / adverse effects*
  • Embolization, Therapeutic / methods
  • Endovascular Procedures / methods
  • Humans
  • Middle Aged
  • Occipital Lobe / blood supply
  • Postoperative Complications / etiology
  • Postoperative Complications / surgery