Traumatic pseudoaneurysms of the superficial temporal artery: Case series, anatomy, and multidisciplinary treatment considerations

Pseudoaneurysms of the superficial temporal artery (STA) are rare vascular lesions of the external carotid artery system and are most often incurred after blunt head trauma. Diagnosis can be made on clinical grounds, and is confirmed by ultrasonography (US) or CT angiography. Surgical ligation and excision of the aneurysm remains a definitive treatment modality. Patients with STA pseudoaneurysms are often referred to a neurovascular specialist given the neurovascular origin and gross anatomic location of these lesions. Three patients presented to our neurovascular service several weeks following blunt head injury to the anterolateral skull surface with progressive, palpable, pulsatile masses. Each patient underwent CT angiography, which demonstrated a pseudoaneurysm of the frontal branch of the STA, followed by operative ligation and en bloc excision. The present series highlights the anatomical considerations relevant to STA injury and pseudoaneurysm formation following blunt head trauma and reviews the necessary diagnostic and treatment considerations.