True aneurysms of the superficial temporal artery: Diagnosis and treatment

True aneurysms arising from the superficial temporal artery (STA) are quite uncommon. The present study reviews the surgical experience with true STA aneurysms to describe the clinical features and treatment options.

This study comprised of 12 patients (6 female; mean age, 44.7 years) of spontaneous aneurysms of the STA who have undergone the surgical or endovascular treatment. All the patients had no history of trauma or surgery to the head and neck. The clinical presentation, radiographic findings, pathological and laboratory data, and treatment outcomes were retrospectively analyzed.

A pulsatile and progressively growing lump in the STA area was the symptom leading to clinical attention. None neurological defects existed. Six patients had frontal lesions, two had parietal and the remaining 4 patients had preauricular region aneurysms. Imaging studies revealed that the subcutaneous mass was a saccular aneurysm accompanied by the afferent and efferent vessels. The lesions ranged in size from 8 to 23 mm (mean, 11.7 mm). Aneurysm trapping and excision was performed in 11 patients. Pathological examination confirmed a true aneurysm of the STA.

True STA aneurysms are usually discovered as a pulsating mass over the temple and their diagnosis could be done with ultrasonography, and computed tomography and magnetic resonance angiography. Simple ligation and resection of the aneurysm is safe and curative.