Clinical Practice and Cases in Emergency Medicine

Introduction: Point-of-care ultrasound (POCUS) allows emergency physicians to rapidly diagnose vascular abnormalities, including pseudoaneurysms. Although commonly identified following vascular catheterization, traumatic pseudoaneurysms of superficial scalp arteries are rare.

Case Report: An 85-year-old woman receiving anticoagulation presented to the emergency department (ED) for removal of a scalp staple placed during treatment of a previously bleeding scalp wound. Physical examination revealed a persistent scalp hematoma. Point-of-care ultrasound demonstrated a hypoechoic collection with Doppler flow consistent with a pseudoaneurysm. Computed tomography angiography confirmed the diagnosis. Ultrasound-guided compression attempted in the ED resulted only in transient thrombosis. The patient subsequently underwent elective percutaneous embolization.

Conclusion: Emergency physician–performed POCUS can rapidly identify traumatic scalp pseudoaneurysms and facilitate timely consultation and treatment.