Korean J Radiol.  2005 Mar;6(1):37-40. 10.3348/kjr.2005.6.1.37.

Posttraumatic Pseudoaneurysm in Scalp Treated by Direct Puncture Embolization Using N-Butyl-2-Cyanoacrylate: a Case Report

• Yang HJ
• Choi YH

• KMID: 1783171
• DOI: http://doi.org/10.3348/kjr.2005.6.1.37

Abstract

Here, we report a case of scalp pseudoaneurysm which was treated by direct puncture embolization using n-butyl-2-cyanoacrylate. The patient had a history of blunt trauma in the previous two months. Ultrasound-guided manual compression was initially attempted, but the results were unsatisfactory. Direct puncture embolization was then performed, and the pseudoaneurysm was completely obliterated. Non-surgical treatment options for pseudoaneurysm are briefly discussed.

Keyword

Scalp; Pseudoaneurysm; Embolization

MeSH Terms

Accidental Falls
Aged
Aged, 80 and over
Aneurysm, False/diagnosis/etiology/*therapy
Cyanoacrylates/*therapeutic use
Embolization, Therapeutic/*methods
Female
Humans
Punctures
Scalp/*injuries
Tomography, X-Ray Computed
Ultrasonography, Doppler

Figure

• 

  Fig. 1 Enhanced CT scan (A) and left occipital arteriogram (B) reveal a pseudoaneurysm in the scalp.

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  Fig. 2 Doppler ultrasonogram five days after manual compression reveals a crescent-shaped residual blood flow.

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  Fig. 3 Direct puncture embolization of pseudoaneurysm. Test injection of contrast media after puncture (A) reveals reflux flow to the proximal occipital artery, in spite of cautious injection. Manual compression of the proximal occipital artery greatly reduces the extent of the reflux (B). After injection of a mixture of N-butyl-2-cyanoacrylate and Lipiodol during the manual compression of the proximal occipital artery, the cast-filling pseudoaneurysm is easily visualized on the fluoroscope (C).

• 

  Fig. 4 Color Doppler ultrasonogram eight days after embolization reveals the complete disappearance of flow into the pseudoaneurysm.

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