Nightmare accident leads to superficial temporal artery aneurysm

Superficial temporal artery aneurysms (STAAs) are rare vascular lesions that typically occur after a minor head trauma. The superficial temporal artery is susceptible to injury due to the anatomical position of this vessel over the frontal bone with only relatively thin muscles, the temporalis and frontalis muscles, providing underlying protection. STAAs most commonly present as a painless pulsatile mass. Here we present a case of traumatic STAA presenting in delayed fashion after impact of the head on a nightstand when the patient fell out of bed during a nightmare. Work-up included duplex ultrasound, which depicted focal 8 mm aneurysmal dilatation of the proximal superficial temporal artery. The artery measured 2.0 mm in the adjacent segment, representing a 3.7× size increase. The patient was treated with ligation and excision. We further discuss management options for management of STAAs.