E1560. Not Your Ordinary Goose-Egg: A Case of Pseudoaneurysm Arising from the Superficial Temporal Artery and Literature Review
Authors
Saumik Rahman;
Yale University School of Medicine
Balaji Rao;
Yale University School of Medicine
Background
The superficial temporal artery (STA) is a branch vessel arising from the external carotid artery, which courses along the lateral aspect of the skull and supplies the scalp. The literature has described rare case reports of traumatic injury to this vessel, leading to the formation of focal pseudoaneurysm. This is an important entity for radiologists to be able to recognize in the appropriate clinical setting. This educational exhibit hopes to familiarize practicing radiologists and trainees with this rare vascular entity and provide context in the setting of the current available literature.
Educational Goals / Teaching Points
Understand the anatomy of the external carotid artery and course of the STA. Describe the potential etiologies and natural history of STA pseudoaneurysm. Describe the imaging findings of STA pseudoaneurysm on cross sectional imaging and sonography. Identify possible differential diagnoses which may mimic STA pseudoaneurysm. Discuss the treatment options for STA pseudoaneurysm.
Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
STA pseudoaneurysm typically presents weeks after blunt traumatic injury to the temporal region. This entity may be confused with other traumatic or nontraumatic superficial lesions, such as a cyst or hematoma. Computed tomographic angiography (CTA) is able to clearly delineate the anatomy of the pseudoaneurysm sac and define the presence of intraluminal thrombosis. Ultrasonography with color and spectral doppler interrogation may further delineate the anatomy of the pseudoaneurysm neck and describe flow dynamics within the STA and pseudoaneurysm itself. Treatment options include both traditional surgical resection and newer endovascular/percutaneous interventional techniques.
Conclusion
STA pseudoaneurysm is a rare clinical entity that may present weeks after blunt trauma. The emergency radiologist should be aware of this entity as a possible differential consideration in the appropriate clinical setting and able to provide appropriate recommendations for both imaging and therapeutic options.
