• Journal of Cerebrovascular and Endovascular Neurosurgery
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• 제25권4호
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• pp.434-439
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• 2023

Pseudoaneurysms are rare but devastating complications of penetrating head traumas. They require rapid surgical or endovascular intervention due to their high risk of rupture; however, complex presentations may limit treatment options. Our objective is to report a case of severe vasospasm, flow diversion, and in-stent stenosis complicating the treatment of a middle cerebral artery pseudoaneurysm following a gunshot wound. A 33-year-old woman presented with multiple calvarial and bullet fragments within the right frontotemporal lobes and a large right frontotemporal intraparenchymal hemorrhage with significant cerebral edema. She underwent an emergent right hemicraniectomy for decompression, removal of bullet fragments, and evacuation of hemorrhage. Once stable enough for diagnostic cerebral angiography, she was found to have an M1 pseudoaneurysm with severe vasospasm that precluded endovascular treatment until the vasospasm resolved. The pseudoaneurysm was treated with flow diversion and in-stent stenosis was found at 4-month follow-up angiography that resolved by 8 months post-embolization. We report the successful flow diversion of an middle cerebral artery (MCA) pseudoaneurysm complicated by severe vasospasm and later in-stent stenosis. The presence of asymptomatic stenosis is believed to be reversible intimal hyperplasia and a normal aspect of endothelial healing. We suggest careful observation and dual-antiplatelet therapy as a justified approach.

• Journal of Trauma and Injury
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• 제25권1호
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• pp.32-35
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• 2012

Traumatic pseudoaneurysms in the head and neck region are very rare. Particularyly, pseudoaneurysms of the internal maxillary artery are known to be very rare. The authors report a 20-year old male who was diagnosed as having a pseudoaneurysm of the internal maxillary artery. The cause was assumed to be a mandible ramus fracture. When he visited our emergency room, we did not consider a pseudoaneurysm because of his other life-threatening conditions. Fortunately, he re-visited our hosipital before the aneurysm ruptured. He was diagnosed with angiography and was treated by using embolization with glue. The rupture of the pseudoaneurysm could have caused a life-threatening hemorrhage.

• Journal of Korean Neurosurgical Society
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• 제56권5호
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• pp.423-427
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• 2014

Traumatic pseudoaneurysms of the middle meningeal artery (MMA) are rare phenomenon, which are usually associated with head trauma such as an underlying skull fracture. They were usually known to cause acute or delayed epidural hematomas but can be associated with subdural, subarachnoid, or even intracerebral hemorrhage. Sometimes, a high mortality rate was reported in these circumferences. But the natural course of these pseudoaneurysms is not well recognized. The indication and guideline of treatment for pseudoaneurysm are also unclear. This report describes a rare case of angiographically progressive change of traumatic pseudoaneurysm of the middle meningeal artery for one week, which was treated with endovascular embolization.

• Journal of Korean Neurosurgical Society
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• 제43권4호
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• pp.209-211
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• 2008

Pseudoaneurysm arising from the superficial temporal artery (STA) is a rare and potentially critical cause of palpable mass. Most pseudoaneurysms form as a result of blunt trauma and present as painless, pulsatile mass that may be associated with pathologic finding and enlarged size. We report a rare case of pseudoaneurysm arising from STA caused by blunt injury and diagnosed by 3-dimensional computed tomography (CT) angiography.

• Journal of Korean Neurosurgical Society
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• 제38권2호
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• pp.141-143
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• 2005

We report a case of pseudoaneurysm formation after aneurysmal clipping. An aneurysm, which was located on the beginning of orbitofrontal artery, was clipped and wrapped with $Surgicel^{(R)}$ and fibrin glue. Four weeks later, an enlarged aneurysm was detected at the same site on postoperative angiography. We could not find a new aneurysm in the second operation except inflated wrapping region. And clip had been slipped from the original aneurysmal neck. So we concluded that a new aneurysm was a pseudoaneurysm made with surgicel and fibrin glue. And it had been formed from continuous minor leakage caused by slipped clip.

• Journal of Chest Surgery
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• 제45권6호
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• pp.408-411
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• 2012

A 51-year-old male with sustained fever was diagnosed with military tuberculosis and tuberculous aortitis complicated with pseudoaneurysm formation at the proximal descending aorta. A follow-up computed tomography evaluation showed an increased size of the pseudoaneurysm in this area, suggestive of a contained rupture. Consequently, the patient underwent emergency excision and replacement of the aorta using a left heart bypass. The patient was discharged without postoperative complications on post-operative day 12. During the one-year follow-up period, the patient was free of any complications or recurrence of tuberculosis. We report a case of pseudoaneurysm of the descending aorta that was successfully surgically repaired.

• Journal of Chest Surgery
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• 제51권3호
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• pp.213-215
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• 2018

Aneurysm and pseudoaneurysm of the dorsalis pedis artery (DPA) are rare vascular entities. Pseudoaneurysms of the DPA are commonly due to blunt trauma, sharp penetrating injury, fracture, or iatrogenic injury. Herein, we report the case of a patient with a rare iatrogenic pseudoaneurysm that occurred after blood sampling. The diagnosis was suspected based on palpitation of a pulsatile mass on the dorsal foot and confirmed by color Doppler ultrasound and computed tomography angiography. Surgical treatment was successfully performed by reconstruction with an autologous venous graft. The patient recovered well, with no ischemic complications.

• Nuclear Medicine and Molecular Imaging
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• 제41권4호
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• pp.337-338
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• 2007

A 20-year-old man underwent a Tc-99m HMPAO labeled leukocyte scan for the evaluation of an infection at the stump of an AK amputation, which was conducted due to an open communicated fracture of the left lower leg. Blood-flow and blood-pool images demonstrated a pseudoaneurysm with a focus of intense activity medial to the stump, and centered within a large photopenic defect by surrounding hematoma. Delayed image obtained at 3 hours post-injection showed persistent intense and slight increased activity, Contrast angiography confirmed the presence of a pseudoaneurysm arising from a branch of the left superficial femoral artery.

• The Korean Journal of Pain
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• 제26권2호
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• pp.191-194
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• 2013

Pseudoaneurysm of the abdominal wall is a possible but very rare clinical entity. It is a known complication of surgery, trauma, or arterial puncture, but it is rarely spontaneous. Even though it can usually present with a wide range of local symptoms, it can cause referred pain via spinal cord, which is cross-excited with afferent sympathetic nervous system. We report a case of right arm pain which was referred from a small abdominal pseudoaneurysm like a referred pain from gall bladder. This rare entity should be considered in the differential for pain management in case that the pain does not resolve with medication or interventional pain management.

• Journal of Chest Surgery
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• 제30권2호
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• pp.213-218
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• 1997

저자들은 4례의 가성 흉부대동맥류를 외과적으로 치료하였는데 개심술후와 대동맥치환술후에 발생 한 예가 각 1례씩 이었고 2례는 교통사고에 의한 흉부둔상후 발생하였다. 심실중격결손증으로 개심술을 받았던 1례에서는 대동맥도관과 심정지액도관을 삽입하였던 부위로 생각되는 상행대동맥에서 발생하 였고, 하행대동맥에 발생한 죽상대동류로 대동백치환술을 받았던 1례에서는 인조혈관의 봉함부위에서, 그리고 교통사고에 의한 흉부둔상의 예에서는 좌쇄골동맥 기시부 직하방에서 발생하였다. 개심술 및 대 동백치환술을 받았던 환자들에서는 감염이 발병원인으로 생각되었고 외상환자에서는 하행대동맥의 파 열이 원인이었다. 외상에 의한 1례가 술후 3일째쉐 사망하였는데 수상시 동반된 담즙성 복막염에 의한 패혈증으로 사망하였다. 생존한 3례는 술후 10개월에서 18개월이 경과하였는데 특별한 합병증은 발견 되 지 않고 있다. 이상의 소견으로 미루어 외상에 의한가성대동류가의심되는 경우에서는타장기 손상의 합병을 충분히 검토하여야 하고 개심술이나 대동백치환술후 추적관찰 중에도 드물게 발생하는 가성 흉부대동맥류가 발견되면 곧바로 외과적 \ulcorner치술을 시행하면 양호한 성적을 기대할 수 있을 것으로 생각된다.