Traumatic pseudoaneurysms of external carotid artery branch:Case series and treatment considerations

Purpose:To explore the diagnosis and treatment of traumatic external carotid branch pseudoaneurysms.Methods:Eleven cases of traumatic external carotid artery branch pseudoaneurysms were admitted in our hospital.Digital subtraction angiography was performed in all patients.It revealed that the pseudoaneurysms originated from the internal maxillary artery in 5 cases,superficial temporal artery in 5 cases and occipital artery in 1 case.Five cases of internal maxillary artery pseudoaneurysms and 2 cases of superficial temporal artery pseudoaneurysms were treated by embolization;the other 3 cases were surgically resected.Results:Complete cessation of nasal bleeding was achieved in all the 5 pseudoaneurysms of internal maxillary artery after the endovascular therapies.Scalp bleeding stopped and scalp defect healed up in 2 patients with superficial temporal artery pseudoaneurysms treated by interventional therapy.All patients were followed up for 0.5-2.0 years without recurrence of nosebleed and scalp lump.Conclusion:For patients with repeated severe epistaxis after craniocerebral injury,digital subtraction angiography should be performed as soon as possible to confirm traumatic pseudoaneurysm.Endovascular therapy is an effective method for traumatic internal maxillary artery pseudoaneurysms.For patients with scalp injuries and pulsatile lumps,further examinations including digital subtraction angiography should be performed to confirm the diagnosis.Surgical treatment or endovascular therapy for scalp traumatic pseudoaneurysm is effective.

Cerebral blood flow volume measurements of the carotid artery and ipsilateral branches using two-dimensional phase-contrast magnetic resonance angiography

The optimal velocity encoding of phase-contrast magnetic resonance angiography （PC MRA） in measuring cerebral blood flow volume （BFV） ranges from 60 to 80 cm/s. To verify the accuracy of two-dimensional （2D） PC MRA, the present study localized the region of interest at blood vessels of the neck using PC MRA based on three-dimensional time-of-flight sequences, and the velocity encoding was set to 80 cm/s. Results of the measurements showed that the error rate was 7.0±6.0% in the estimation of BFV in the internal carotid artery, the external carotid artery and the ipsilateral common carotid artery. There was no significant difference, and a significant correlation in BFV between internal carotid artery ＋ external carotid artery and ipsilateral common carotid artery. In addition, the BFV of the common carotid artery was correlated with that of the ipsilateral internal carotid artery. The main error was attributed to the external carotid artery and its branches. Therefore, after selecting the appropriate scanning parameters and protocols, 2D PC MRA is more accurate in the determination of BFV in the carotid arteries.

Challenges of Management of Arteriovenous Malformation of the Pinna in a Low Resource Setting: A Case Report

Arteriovenous Malformation (AVM) is a lesion of vascular development characterized by an abnormal communication between an artery and a vein without an intervening capillary bed. AVM of the pinna is very rare with very few reported cases in Africa. Management of an AVM is often daunting, most especially in a resource challenged centre like ours where facilities for super selective embolization are not available. We present the case of a 17-year-old female with a pulsatile swelling of the left pinna since childhood. Clinical and radiological diagnosis of arteriovenous malformation was made. She was managed surgically with left external carotid artery ligation, partial auricular resection and postauricular scalp rotation flap cover of the cartilage remnant. The aetiopathogenesis, clinical presentation, diagnostic confirmation and treatment options are discussed. We also discuss the challenges of managing AVM in poor resource settings like ours.

Surgical Treatment of Superior Thyroid Artery Aneurysm with Concomitant Thyroid Cancer

In 2015, the incidence rate of thyroid cancer was 4.2/100,000 in China, which accounted for 2.1% of all new cancer cases.[1] Aneurysmsofthecarotidarteryoritsbranchesaccountforonly 0.4% of all peripheral artery aneurysms.[2] The coexistence of these two lesions has seldom been observed. Here, we reported a case of a superior thyroid artery （STA） aneurysm with concomitant thyroid cancer and discussed surgical treatment strategies.