Superficial temporal artery aneurysm: Beware of the lump with a thump

Pseudoaneurysm of the Superficial Temporal Artery—Two Case Reports of a Rare Entity

“…10 While patients are typically concerned with the cosmetic deformity of an aneurysmal dilatation of temporal vessels, potential for enlargement of the lesion or hemorrhage serves as the primary indication for resection. 13,15 Studies have shown that 89% of pseudoaneurysms self-resolve within 5 to 90 days; however, medical management is not recommended as the risks of hemorrhage, progressive symptomology, and poor cosmesis cannot be understated. 4 Primary excision of the lesion with distal and proximal vessel ligation remains the most conservative and popular approach to surgical management as it can be accomplished under local or general anesthetic with good outcomes and minimal morbidity.…”

“…18 With regard to the face, the anterior branch of the STA is most susceptible to trauma at two locations: first, as it superficially crosses the bony zygomatic arch and second, at the superior temporal line of the skull. 15,18,19 The complex anatomy of this region due to the proximity of the STA to the facial nerve and parotid can influence approaches to management as seen in Case 2 when the plan switched from excision to endovascular embolization. Furthermore, an intimate understanding of the anatomy of the STA and its course through the parotid and its proximity to the facial nerve is imperative to avoid an intraoperative situation where profuse bleeding can only be controlled by blind suture ligation.…”

Superficial Temporal Artery Pseudoaneurysm: A Case Report

“…Surgical management under local anesthetic is appropriate and may include ligation and excision of the aneurysmal arterial segment or primary repair when the arterial injury is easily amenable to closure with sutures ( 1 ). Other treatment options for STA aneurysm have been reported, including endovascular obliteration, percutaneous endo-obliteration using coils, glue, or ethylene vinyl alcohol copolymer ( 3 ). Percutaneous thrombin injection as a treatment has been described with controversies ( 6 ).…”

“…Percutaneous thrombin injection as a treatment has been described with controversies ( 6 ). Recurrence rate after surgery have been documented as rare ( 3 ). In our patient surgical excision of pseudoaneurysm was carried out with no recurrence post-surgery.…”

“…A pseudoaneurysm is a dilation of an artery that includes a defect in one or more layers of arterial wall ( 1 ). Pseudoaneurysm of the superficial temporal artery is a rare ( 2 , 3 ) clinical entity that typically occurs after a blunt trauma ( 1 , 4 – 6 ) to the frontotemporal region ( 5 ). There are reports of such traumatic pseudoaneurysms of superficial temporal artery ( 1 , 2 , 6 – 9 ), but within the context of craniotomy as a cause of pseudoaneurysm only few cases ( 2 ) have been described throughout the world.…”