PMC3515923_01
Subcutaneous enlarging mass in the left temporal region
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PMC3515923_01_SNI-3-139-g001.jpg
F1
On postoperative day 22, a mass was noted in the left temporal region as seen in Figure 1.
(a) Noncontrast axial CT image revealing a partially hypodense-isodense complex fluid collection superior to the zygoma, 3.6 cm in its greatest dimension. (b) Axial T1-weighted MRI revealing a 3.6 cm hyperintense fluid collection without and (c) with gadolinium, that is homogeneously enhancing. (d) Left selective STA injection, antero-posterior and (e) lateral projections show circular area of contrast blush. (f) Postcoiling angiogram, left ECA injection, antero-posterior projection, shows coils in superficial temporal artery and resolution of contrast blush
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F2
A head CT scan was performed initially and showed a partially hypodense-isodense fluid-filled mass just superior to the zygoma and adjacent to the lower part of the craniotomy site [Figure 2a]. T1WI, heterogeneous on T2WI with pulsation artifacts and homogeneous enhancement [Figure 2b and c]. The suspected diagnosis of an STA pseudoaneurysm was confirmed by transfemoral angiography [Figure 2d and e]. Onyx (ev3 Inc.). On the final postintervention angiogram, no contrast opacification was seen within the pseudoaneurysm [Figure 2f].