Traumatic Pseudo-Aneurysms of the Superficial Temporal Artery-2 Case Reports and Review of the Literature

Abstract

Background:Pseudo-aneurysms of the superficial temporal artery (STA) are uncommon. Most cases are related to incidental traumas such as contusions from sports-related injuries, traffic accidents, gunshot wounds or stab wounds. Although imaging studies are helpful tools in diagnosing pseudo-aneurysms, the importance of history and physical examination should not be underestimated.Aim and Objectives:We present two cases to highlight the importance of taking a thorough history and paying attention to signs and symptoms. In addition, we also review the literature on pseudo-aneurysms and discuss the pathophysiology, diagnosis and treatment options.Materials and Methods:Two cases are described who were seen several weeks after having had an initial assessment in a different Unit for a blunt head injury. During initial assessment, ecchymosis was diagnosed but ignored. After taking a thorough history, doing physical examination and performing Doppler sonography in one patient, the pseudo-aneurysms of the STA was diagnosed.Result:They were both consulted by our Unit at a later date and pseudo-aneurysms were found. Both patients underwent segmental ligation of involved Superficial Temporal Artery (STA) and removal of the pseudo-aneurysm with good outcomes.Conclusion:The importance of doing a thorough history and paying attention to the physical signs and symptoms are emphasized in this paper. In particular, when patients present with closed head injuries and ecchymosis, one should have a high level of suspicion. Doppler sonography should be the first choice of imaging and surgical resection is the prefered treatment for pseudo-aneurysms.