Pseudoaneurysms of the superficial temporal artery: treatment options.

OBJECTIVES

Pseudoaneurysms of the superficial temporal artery present as slowly growing masses of the face or scalp. They may arise as a result of infection or autoimmune disease but most commonly are sequelae of blunt, penetrating, or surgical trauma. We describe their clinical presentation and differential diagnosis and compare several treatment options.

STUDY DESIGN

Observational case series.

METHODS

We retrospectively reviewed the presentations, diagnostic evaluations, and management in three young men who presented with pseudoaneurysms after trauma. A computerized review of the world's literature revealed a variety of methods for the control of head and neck pseudoaneurysms.

RESULTS

Surgical resection, ligation without resection, intravascular sclerosis, and coil embolization have all been used to treat these lesions. We treated two lesions by coil embolization and one by surgical resection. Long-term control was achieved in each case.

CONCLUSIONS

Surgical resection cures pseudoaneurysms in most cases. The frontal and zygomatic branches of the facial nerve are at risk during this procedure. Local sclerosis is effective but may cause distal tissue necrosis. Coil embolization is highly effective and leaves no facial scar but carries small risks of stroke, lower extremity ischemia, and groin pseudoaneurysm.