Superficial Temporal Artery Pseudoaneurysm

Pseudoaneurysms of the superficial temporal artery are an uncommon vascular lesion of the external carotid system and most often the result of blunt head trauma. Causes include sports-related trauma, non-sports related trauma, i.e. gun-shot wounds, assault, etc., and iatrogenic causes such as after cyst removal, punch hair grafting, and craniotomies.

The anterior branch of the STA is most vulnerable to injury from blunt trauma due to its superficial course and close proximity to the underlying bony structures.

The time period from craniotomy to pseudoaneurysm in the literature varied between 4 days and 3 months. Differential diagnoses for STA pseudoaneurysm include vascular tumor, arteriovenous fistula, meningeal artery aneurysm with bony erosion, subcutaneous lipoma, abscess, and localized hematoma.

The following is a case of left Superficial Temporal Artery pseudoaneurysm in a 69yr old female, arising after a trauma to the side of the head, hitting an open window, 2 years back, with transient loss of consciousness. Swelling was slowly increasing in size.

The ultrasound image below shows a clear defect in the STA vessel wall of ~6.8mm length, with the pseudoaneurysm measuring ~16mm x 11mm.

References:

Superficial Temporal Artery Pseudoaneurysm: A Case Report

Syed Muneeb Younus, Muhammad Imran, Rabia Qazi

Front Surg. 2015; 2: 51. Published online 2015 Oct 6. doi: 10.3389/fsurg.2015.00051

PMCID: PMC4593946

Primary repair of a traumatic superficial temporal artery pseudoaneurysm: case report and literature review. Ayling O, Martin A, Roche-Nagle G, Vasc Endovascular Surg. 2014 May; 48(4):346-8.

Ruptured pseudoaneurysm of the superficial temporal artery after craniotomy.

Honda M, Anda T, Ishihara T, Neurol India. 2013 Nov-Dec; 61(6):698-9.

http://www.ajnr.org/content/cow/10252010