Itani Masahiko, Shimizu Kampei, Tani Shoichi, Fujimoto Motoaki, Ogata Hideki, Yoshida Shota, Hirata Yoshihito, Akiyama Yoshinori
Department of Neurosurgery and Stroke Center, Tenri Hospital, Tenri, Japan.
Surg Neurol Int. 2022 Dec 9;13:573. doi: 10.25259/SNI_848_2022. eCollection 2022.
Nontraumatic true superficial temporal artery aneurysm (STAA) is rare, and its characteristics and pathogenesis are unclear.
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.
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.
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.
非创伤性真性颞浅动脉动脉瘤（STAA）较为罕见，其特征和发病机制尚不清楚。
我们报告一例STAA病例，并使用关键词“颞浅动脉动脉瘤”对PubMed、Scopus和Web of Science进行系统综述，以纳入截至2022年7月报道的关于STAA的研究。我们排除了与创伤、动脉夹层、感染或血管炎相关的STAA研究。
一名63岁女性在8年前接受了左颞浅动脉（STA）-大脑中动脉搭桥手术，被诊断出左STA处有一个动脉瘤。超声估计左STA的血流量高于对侧（114 mL/分钟对32 mL/分钟）。她接受了夹闭手术以防止动脉瘤破裂，术后无后遗症。组织学诊断该病变为真性动脉瘤。系统综述确定了63例（包括本病例）非创伤性真性STAA。患者的中位年龄为57岁（四分位间距[IQR]：41 - 70岁）。大多数（90.5%）病例表现为可触及的肿块。尽管动脉瘤尺寸较大（中位大小：13 [IQR：8 - 20] mm）且观察期间动脉瘤生长频率较高（33.3%），但仅1例（1.6%）发生动脉瘤破裂。大多数（93.7%）患者接受了STAA手术切除，术后无后遗症。
我们的研究结果表明，血流动力学应激促进了真性STAA的发病机制。系统综述明确了患者和动脉瘤的特征以及治疗结果，为非创伤性真性STAA的发病机制提供了进一步的见解。
