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Alkhaibary A, Alharbi A, Alsubaie N, Alghanim N, Khairy S, Ozair N, Baydhi L, Musawnaq F, Almuntashri M, Alarifi A, Alwohaibi M, Aloraidi A, Alokaili R, Alkhani A. Traumatic superficial temporal artery pseudoaneurysm: Successful management using endovascular embolization. Radiol Case Rep 2021; 17:416-419. [PMID: 34934467 PMCID: PMC8654609 DOI: 10.1016/j.radcr.2021.10.064] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 10/25/2021] [Accepted: 10/27/2021] [Indexed: 11/30/2022] Open
Abstract
Superficial temporal artery pseudoaneurysms are uncommon but can be potentially life-threatening. Considering their rarity, the present article outlines the clinical presentation, radiological findings, intervention, and outcome of traumatic pseudoaneurysm of the superficial temporal artery. An 83-year-old female sustained a traumatic injury to the temple, resulting in right-sided swelling of the forehead. Brain computed tomography and cerebral angiogram revealed a right-sided homogenously-enhancing pseudoaneurysm in the frontal region. Successful occlusion of the lesion was achieved utilizing endovascular embolization. Three months after discharge, the patient reported no complaints or recurrence. Subsequent management included reassurance and observation with periodic clinical assessments. The unusual presentation of superficial temporal artery pseudoaneurysms requires clinicians to have thorough knowledge on the clinical presentation, proper steps in diagnosis, and the approach of choice in management. Endovascular embolization of superficial temporal artery pseudoaneurysms remains a valid approach to achieve successful occlusion of the lesion.
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Affiliation(s)
- Ali Alkhaibary
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.,King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.,Division of Neurosurgery, Department of Surgery, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Ahoud Alharbi
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.,King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.,Division of Neurosurgery, Department of Surgery, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Noura Alsubaie
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.,King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Noor Alghanim
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Sami Khairy
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.,King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.,Division of Neurosurgery, Department of Surgery, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Nabil Ozair
- Medical Imaging Department, King Abdulaziz Medical City, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia
| | - Laila Baydhi
- College of Medicine, Jazan University, Jazan, Saudi Arabia
| | - Fahd Musawnaq
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.,King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.,Division of Neurosurgery, Department of Surgery, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Makki Almuntashri
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.,King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.,Medical Imaging Department, King Abdulaziz Medical City, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia
| | - Abdulaziz Alarifi
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.,Division of Neurosurgery, Department of Surgery, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Mohammed Alwohaibi
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.,Division of Neurosurgery, Department of Surgery, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Ahmed Aloraidi
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.,King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.,Division of Neurosurgery, Department of Surgery, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Riyadh Alokaili
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.,King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.,Division of Neurosurgery, Department of Surgery, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia.,College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Ahmed Alkhani
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.,Division of Neurosurgery, Department of Surgery, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
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Superficial Temporal Artery Pseudoaneurysm following Midface Thread-lift. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2021; 9:e3524. [PMID: 33868876 PMCID: PMC8049386 DOI: 10.1097/gox.0000000000003524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Accepted: 02/14/2021] [Indexed: 11/26/2022]
Abstract
Facial thread-lifting has been popular because of its ease and safety with short down time. However, many physicians perform the procedure in cosmetic clinics, which can result in several complications. This report describes the surgical treatment of iatrogenic superficial temporal artery pseudoaneurysm (STAP) following thread-lifting. A 27-year-old man developed a painless, pulsating soft mass in the pre-auricular region after undergoing a thread-lift in a private cosmetic clinic 3 months before being referred to the authors’ hospital. The mass was diagnosed as a STAP, using magnetic resonance imaging. The pseudoaneurysm was resected completely, and the superficial temporal artery was microsurgically reconstructed. Although there are some surgical procedures for treating STAP, such as surgical resection and embolization, the former is considered the first choice. Physicians should be trained before performing thread-lifting and must know the possibility of an iatrogenic STAP appearing after the procedure and the face and neck anatomy to prevent complications.
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Terterov S, McLaughlin N, Martin NA. Postcraniotomy superficial temporal artery pseudoaneurysm in the setting of triple H therapy: A case report and literature review. Surg Neurol Int 2012; 3:139. [PMID: 23230520 PMCID: PMC3515923 DOI: 10.4103/2152-7806.103877] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2012] [Accepted: 09/20/2012] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Superficial temporal artery (STA) pseudoaneurysm after a craniotomy is very rare with only five cases reported in the literature, none manifesting in the setting of cerebral vasospasm treatment with triple H therapy. CASE DESCRIPTION A 31-year-old male was admitted after a syncopal episode. Imaging documented a ruptured anterior communicating artery aneurysm. He was taken to the operating room for aneurysm clipping, but the procedure was aborted due to intraoperative aneurysm re-rupture, at which point the patient underwent emergent coil embolization of the aneurysm. The postoperative course was complicated by severe cerebral vasospasm requiring prolonged triple H therapy. On postoperative day 22, a growing left temporal mass with a bruit was noted. The suspected diagnosis of STA pseudoaneurysm was confirmed by femoral angiography, and it was treated with coils and Onyx embolization. CONCLUSION We report the first case of a postcraniotomy STA pseudoaneurysm in the setting of induced hypertension for the treatment of cerebral vasospasm. Endovascular embolization is a viable option for the treatment of an STA pseudoaneurysm.
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Affiliation(s)
- Sergei Terterov
- Department of Neurosurgery, David Geffen School of Medicine at UCLA, 757 Westwood Plaza, Suite 6236, Los Angeles, CA, USA
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van Uden DJP, Truijers M, Schipper EE, Zeebregts CJ, Reijnen MMPJ. Superficial temporal artery aneurysm: Diagnosis and treatment options. Head Neck 2012; 35:608-14. [PMID: 22302542 DOI: 10.1002/hed.21963] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2011] [Revised: 08/11/2011] [Accepted: 09/06/2011] [Indexed: 11/07/2022] Open
Abstract
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.
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Mousa AY, Jain AK, Campbell JE, Stone PA, AbuRahma AF. Degenerative (true) superficial temporal artery aneurysm: a case report with review of literature. Vasc Endovascular Surg 2011; 45:568-71. [PMID: 21844493 DOI: 10.1177/1538574411414303] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This is a case report of a 72-year-old female who presented to our clinic with right temple mass that was found incidentally on a magnetic resonance imaging (MRI) of her head about 2 years ago, as part of a stroke workup. However, it was thought to be a sebaceous cyst and left as such. The patient then experienced a rapid increase in the size of the mass about 2 weeks prior to her presentation to us. On examination, she had a 2 × 2 cm pulsating aneurysmal mass over the right temporal fossa, which was felt to be an aneurysm of the superficial temporal artery and was confirmed by a color duplex ultrasound examination. Open surgical resection with primary ligation of both proximal and distal branches was achieved under local anesthesia. Pathology confirmed a true (degenerative) aneurysm of the superficial temporal artery. Her postoperative course was uneventful. This case report describes this rare entity along with a review of the literature.
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Affiliation(s)
- Albeir Y Mousa
- Department of Surgery, R. C. Byrd Health Sciences Center, West Virginia University, Charleston, WV 25304, USA.
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Chatelain B, Meyer C, Vitte F, Ricbourg B. [False aneurysm of the superficial temporal artery: report of two cases]. ACTA ACUST UNITED AC 2009; 110:299-302. [PMID: 19423143 DOI: 10.1016/j.stomax.2009.03.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2008] [Revised: 03/12/2009] [Accepted: 03/18/2009] [Indexed: 10/20/2022]
Abstract
INTRODUCTION False aneurysms of the superficial temporal artery (STA) are rare and usually occur after a direct trauma to one of its branches. It is characterized by the local rupture of the artery wall. The diagnosis is made by clinical history and clinical examination. The treatment is surgery. CASE REPORT Two patients, a 20-year-old man and an 82-year-old man, were referred with a pulsatile mass respectively in the temporal and the frontal area having evolved for several weeks. The diagnosis was made on clinical history (history of trauma was an important clue) and clinical examination (compression of the proximal STA should reduce pulsation) and confirmed by ultrasonography. The treatment was surgical, the STA was ligated proximally and distally and the pseudoaneurysm was resected successfully. DISCUSSION False aneurysms can be differentiated from true aneurysms by a rupture in the arterial wall. A thorough clinical history must screen for the initial trauma often gone unnoticed. The aim of clinical and paraclinical examination is to eliminate other causes of pulsatile tumors that can be found in this area (true aneurysms of the STA or of the meningeal artery).
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Affiliation(s)
- B Chatelain
- Service de chirurgie maxillofaciale et stomatologie, CHRU de Besançon, boulevard Fleming, 25030 Besançon cedex, France.
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