Spontaneously arising superficial temporal artery aneurysms: a report of two cases and review of the literature

Surgical resection of an isolated superficial temporal artery aneurysm

In the present report, we describes a case of surgical resection of an isolated superficial temporal artery aneurysm without underlying systemic pathology. Although aneurysms of this sort most commonly occur in the setting of recent trauma, this case demonstrates an uncommon presentation. We hope to further contribute to the literature regarding this condition.

True superficial temporal artery aneurysm: A case after extracranial-intracranial bypass surgery and a systematic review

Background

Nontraumatic true superficial temporal artery aneurysm (STAA) is rare, and its characteristics and pathogenesis are unclear.

Methods

We report a case of STAA and performed a systematic review of PubMed, Scopus, and Web of Science using the keyword "superficial temporal artery aneurysm" to include studies on STAA reported through July 2022. We excluded studies on STAA associated with trauma, arterial dissection, infection, or vasculitis.

Results

A 63-year-old woman who underwent left superficial temporal artery (STA)-middle cerebral artery bypass surgery 8 years previously was diagnosed with an aneurysm located at the left STA. The blood flow volume estimated by ultrasonography was higher in the left STA than in the contralateral counterpart (114 mL/min vs. 32 mL/min). She underwent clipping surgery to prevent aneurysmal rupture without sequela. The lesion was diagnosed as a true aneurysm by histology. The systematic review identified 63 cases (including the present case) of nontraumatic true STAA. The median age of the patients was 57 (interquartile range [IQR]: 41-70) years. Most (90.5%) cases were detected as a palpable mass. Aneurysmal rupture occurred in only 1 (1.6%) case, despite the large size of aneurysms (median size: 13 [IQR: 8-20] mm) and the high frequency (33.3%) of aneurysmal growth during observation. Most (93.7%) patients underwent surgical resection of STAA without sequela.

Conclusion

Our findings suggest that the pathogenesis of true STAA is promoted by hemodynamic stress. The systematic review clarified patients' and aneurysmal characteristics and treatment outcomes, providing further insight into the pathogenesis of nontraumatic true STAA.

The oldest patient in literature of spontaneous true giant superficial temporal artery aneurysm

Background

Superficial temporal artery (STA) aneurysms are very rare compared to vascular aneurysms of other regions. They are divided into two as true and pseudo. Pseudoaneurysm were much more common and often depend on an etiological factor but spontaneous true aneurysms are extremely uncommon and the etiologic causes are not clear yet.

Case presentation

We present a 91-year-old female patient who consulted to us with swelling in front of the ear; there was no history of previous surgery or any trauma. The patient had a pulsatile mass in the preauricular region, which started 4 years ago and growed faster for the last 2 months.

Conclusion

There was a mass consistent with a saccular type aneurysm whose continuity was observed with the temporal artery in imaging studies. The mass was excised under general anesthesia. The patient whose pathological examination was a true STA aneurysm was discussed in the light of the literature.

True Superficial Temporal Artery Aneurysm Presenting as a Delayed Traumatic Pseudoaneurysm: A Case Report and Review of Literature

A rare case of a true temporal artery aneurysm is presented with review of the literature.

Masson tumor (intravascular papillary endothelial hyperplasia) arising in a superficial temporal artery aneurysm

Masson tumor (intravascular papillary endothelial hyperplasia) is a rare proliferation of endothelial cells within the wall of a vessel, often thought to represent an aberrant resolution of a thrombosis. We describe the unique case of a 75-year-old man who presented to the clinic with a tender, spontaneous aneurysmal dilation of his left superficial temporal artery (STA). Only 8% of all STA aneurysms are believed to be spontaneous true aneurysms, with the majority being post-traumatic pseudoaneurysms. After successful surgical resection, pathologic examination demonstrated a Masson tumor within an STA aneurysm. This paper describes a case in which both rare entities were discovered and briefly outlines the diagnostic and therapeutic modalities available.

Congenital True Aneurysm of the Right Superficial Temporal Artery

Introduction

Superficial temporal artery aneurysms (STAAs) occur in 1% of arterial aneurysms; mostly (95%) are pseudoaneurysms following trauma; true aneurysms are rare (5%); forty-five cases are reported.

Aim

To report a rare case of a congenital STAAA.

Case Report

A67-year-old patient recalled the existence of a true-histologically evidenced- aneurysm of the right superficial temporal artery since his childhood denying any head injury; it was resected through a horizontal skin incisure. Brain arteries' magnetic imaging was negative.

Conclusion

Spontaneous or congenital STAAs have to be removed respecting forehead lines. Intracranial vasculature must be investigated.

True aneurysm of superficial temporal artery accompanying multiple intracranial aneurysm

Superficial temporal artery (STA) aneurysms are very infrequent. Moreover, true aneurysms, which are not pseudoaneurysms associated with trauma or previous surgery are even rarer. With this manuscript, authors present a case of a 79-year-old woman suffering from subarachnoid hemorrhage whose radiological examinations revealed multiple intracranial aneurysms along with an STA aneurysm. This very rare case, to the best of our knowledge, the second case reported so far, might contribute to the literature and lead further investigations toward the rare association between intracranial aneurysms and STA aneurysms.

True aneurysms of the superficial temporal artery: Diagnosis and treatment

OBJECTIVES

True aneurysms arising from the superficial temporal artery (STA) are quite uncommon. The present study reviews the surgical experience with true STA aneurysms to describe the clinical features and treatment options.

METHODS

This study comprised of 12 patients (6 female; mean age, 44.7 years) of spontaneous aneurysms of the STA who have undergone the surgical or endovascular treatment. All the patients had no history of trauma or surgery to the head and neck. The clinical presentation, radiographic findings, pathological and laboratory data, and treatment outcomes were retrospectively analyzed.

RESULTS

A pulsatile and progressively growing lump in the STA area was the symptom leading to clinical attention. None neurological defects existed. Six patients had frontal lesions, two had parietal and the remaining 4 patients had preauricular region aneurysms. Imaging studies revealed that the subcutaneous mass was a saccular aneurysm accompanied by the afferent and efferent vessels. The lesions ranged in size from 8 to 23 mm (mean, 11.7 mm). Aneurysm trapping and excision was performed in 11 patients. Pathological examination confirmed a true aneurysm of the STA.

CONCLUSIONS

True STA aneurysms are usually discovered as a pulsating mass over the temple and their diagnosis could be done with ultrasonography, and computed tomography and magnetic resonance angiography. Simple ligation and resection of the aneurysm is safe and curative.

Three cases of spontaneous superficial temporal artery aneurysm with literature review

Spontaneous, nontraumatic, superficial temporal artery (STA) aneurysms have been rarely reported. We herewith report three cases of spontaneous and true STA aneurysms. All patients, a 65-year-old male, a 76-year-old female, and a 47-year-old female, had no history of head trauma that requires medical attention. Painless, pulsatile, and slowly growing calvarial lump was the symptom leading to image studies. All the lumps were preoperatively diagnosed as STA aneurysms by magnetic resonance angiography and/or three-dimensional computed tomographic angiography. One case was accompanied by anterior communicating aneurysm. And another case was associated with two more scalp aneurysms arising from occipital artery and contralateral STA. Pathologic studies showed that all three were true aneurysms, with intact media and adventitia but without organized hematoma. Literature review showed that 8% of all STA aneurysms comprised spontaneous STA aneurysms. We found 32 cases (19 males and 13 females) of well-described spontaneous STA aneurysms including ours. Twenty-eight cases (87.5%) were true aneurysms. Seven cases (21.9%) had coexisting vascular lesions. Five (15.6%) of these seven cases were diagnosed with cerebral or abdominal aneurysm. Multiple scalp aneurysms are quite rare; only two cases including ours have been reported. It seems important to know that spontaneous STA aneurysms may coexist with other vascular lesions including intracranial aneurysm.

Traumatic true aneurysm of the superficial temporal artery

BACKGROUND

Aneurysms of the superficial temporal artery (STA) usually are pseudoaneurysms and occur after blunt or penetrating trauma to the head or after surgery in the temporal region. However, true aneurysms of the STA are very rare. This report describes the case of a true aneurysm of the STA that appeared after trauma and discusses several relevant studies about the development and mechanism of this aneurysm.

METHODS

A 57-year-old woman was referred to the neurosurgery department due to a slowly growing mass on her left parietal scalp. She reported a history of trauma to the head 3 months before the consultation. However, examination showed the scar located far from pulsatile mass. Imaging studies showed a fusiform aneurysmal dilation of the parietal branch of the STA. The frontal branch likely was occluded due to the previous injury.

RESULTS

Surgical removal was performed, and the proximal STA was ligated. Histologic examination showed all three layers of the arterial wall to be intact and only luminal dilation. No sign of atherosclerosis or inflammation was detected.

CONCLUSION

The aneurysm in this case was a true aneurysm. The mechanism underlying the spontaneous development of this true aneurysm is not fully understood, although it is possible that insensible minor blunt trauma weakened the arterial wall or reduced the elasticity of the artery. Increased blood flow of the parietal branch due to occlusion of the frontal branch can facilitate aneurysmal dilation. It is speculated that the real incidence of traumatic true STA aneurysms has been underreported. Thus, the authors recommend histologic examination in all traumatic aneurysm cases.

LEVEL OF EVIDENCE V

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

A true aneurysm of the zygomatic orbital artery: first case report in the literature

A 33-year-old man presented with a pulsatile mass in the left temporal region; about 1 year before the current presentation, the swelling had arisen on the upper lateral border of the orbital arch and increased in recent months. His medical history was negative for accidental or iatrogenic head injury. Color echo Doppler and angio-computed tomography demonstrated a fusiform aneurysm of the zygomatic orbital artery, a branch of the superficial temporal artery. Blood tests were negative for human immunodeficiency virus (HIV), hepatitis C (HCV), and hepatitis B (HBV) markers. Aneurysmectomy under local anesthesia was performed. Histology of the surgical specimen confirmed the diagnosis of a true aneurysm measuring 8.4 × 5.7 mm, which showed no atherosclerotic degeneration of the vessel walls; the lumen was filled by a recent thrombus but without inflammatory cells. Surgical treatment is indicated for the prevention of rupture, the relief of pain when present, and the removal of facial defects. To the authors' knowledge, this is the first case in the literature of a true aneurysm of the zygomatic orbital artery.

Superficial temporal artery aneurysm: Diagnosis and treatment options

BACKGROUND

Superficial temporal artery (STA) aneurysms are an uncommon entity and mostly described in case studies. The purpose of this review was to show the studied clinical presentation, diagnostic modalities, and treatment modalities of STA aneurysms.

METHODS

A review was performed of reports on STA aneurysms published until December 2010, using the MEDLINE and Cochrane databases.

RESULTS

One hundred sixty-six pseudoaneurysms and 20 true aneurysms were described. The majority of patients presented with a painless pulsatile mass. Historically, angiography was most often used, but ultrasound scan, CT, and MRI may be superior. Surgical resection was performed in 128 pseudoaneurysms and 20 true aneurysms with 1 recurrence and few complications. Endovascular approaches were used in 13% of pseudoaneurysms with an 80% success rate.

CONCLUSION

Pseudoaneurysms are mostly the result of blunt trauma as opposed to true aneurysms which usually occur spontaneously. Surgical resection is a safe treatment modality, but endovascular treatment might be considered in a selected group of patients. © 2012 Wiley Periodicals, Inc. Head Neck, 2013.

Spontaneous nonpulsatile aneurysm of the superficial temporal artery mimicking a subcutaneous mass lesion

True superficial temporal artery (STA) aneurysms are extremely rare and usually atherosclerotic in origin. Here the authors report a 62-year-old man with a nonpulsatile mass lesion at the trace of the right STA that was surgically excised with a preoperative diagnosis of subcutaneous mass lesion, preoperatively and histopathologically found out to be a thrombosed true STA aneurysm. Preoperative evaluation, differential diagnosis, and management of such lesions are discussed.

[Preauricular mass following tympanoplasty]

A 42-year-old man presented with a preauricular subcutaneous pulsating node which had appeared a few weeks after a middle ear operation. CT angiography revealed an aneurysm of the superficial temporal artery. The diagnosis was histologically confirmed after surgical resection of the finding. This is the first description of an aneurysm of the superficial temporal artery as a rare complication of a tympanoplasty. In the presented case, the aneurysm must have been caused either by the surgical trauma of the endaural tympanoplastic incision or the sharp retractors.

Case report of a rare spontaneous superficial temporal artery aneurysm

Unlike posttraumatic temporal artery aneurysm, spontaneous temporal artery aneurysm is an exceptional finding. We report the case of a 34-year-old woman with no history of previous trauma who presented a progressively enlarging right temporal lump. A CT scan revealed a 1.6 cm diameter aneurysm arising from the superficial temporal artery. The aneurysm was surgically resected. The postoperative course was uneventful. Histological examination revealed the presence of intima, media and adventitia.

Superficial temporal artery pseudoaneurysm: first reported case after parotid surgery

OBJECTIVE

To describe a case of superficial temporal artery pseudoaneurysm occurring as a rare complication of parotid surgery (to the authors' knowledge, the first such case reported), to review the aetiology of superficial temporal artery pseudoaneurysm, and to highlight pseudoaneurysm as a cause of facial swelling after parotidectomy.

METHOD

A literature search of the PubMed and EMBASE databases was carried out using the Medical Subject Heading key words 'superficial temporal artery', 'aneurysm', 'pseudoaneurysm' and 'parotid'.

RESULT

No previously reported cases of superficial temporal artery aneurysm or pseudoaneurysm following parotid surgery were identified.

CONCLUSION

Pseudoaneurysm of the superficial temporal artery is a rare complication of parotid surgery which has not previously been reported.

True aneurysms of the superficial temporal artery: report of three cases

Superficial temporal artery aneurysms account for <1% of reported aneurysms. The majority of these aneurysms are a consequence of trauma; however, true superficial temporal artery aneurysms are extremely rare. Here, we present three cases of spontaneous superficial temporal artery aneurysms arising without any previous history of trauma.