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We read with interest the letter by Lee et al describing a case of postoperative superficial temporal artery pseudoaneurysm.1 Although we agree that this complication is rare, we do not agree with their statement, “such a complication after cranial surgery has not previously been reported”. Having recently submitted an identical case to a different journal, we too have reviewed the literature and feel obliged to share our experience.
In 1985, Rousseaux et al reported a case of an STA pseudoaneurysm that developed following a craniotomy for frontal lobe meningioma resection.2
In 1988, Shimoda et al reported a case of multiple STA pseudoaneurysms following a craniotomy.3 Their haemophilic patient sustained a golf ball injury to the left temporal region, which resulted in an intraparenchymal haematoma. An emergent left temporal craniotomy was performed. Forty days after surgery, two separate STA pseudoaneurysms were identified over the incision scar and treated by endovascular embolisation. Although it is conceivable that the golf ball was responsible for the pseudoaneurysms, the relation of the pseudoaneurysms with the incision scar is compelling evidence that they were the result of the craniotomy.
In 2000, an additional case of an STA pseudoaneurysm that developed after a craniotomy was reported by Tsutsumi and colleagues.4
Given the number of craniotomies performed each year along the course of the STA, the occurrence of this complication is exceedingly low, but not unreported.