Background: Traumatic pseudoaneurysms of the superficial temporal artery (STA) are uncommon extracranial vascular lesions that often present with delayed, progressive scalp swelling following head injury. Owing to their superficial location, these lesions carry a risk of rupture, rebleeding, and cosmetic deformity. Endovascular therapy has emerged as a minimally invasive alternative to surgical excision, allowing angiography-guided, goal-directed treatment. Case Description: We report two patients, a 47-year-old man and a 16-year-old boy, who presented with delayed, enlarging temporal swellings following blunt head trauma. Diagnosis was established using colour Doppler ultrasonography, computed tomography angiography, and digital subtraction angiography. Both patients underwent superselective endovascular coil embolization with complete exclusion of the pseudoaneurysm while preserving antegrade flow in the STA main trunk and distal branches. Clinical follow-up at 1 month demonstrated complete resolution of the temporal swelling, with no recurrence, neurological deficit, or vascular compromise at 1 year. Conclusion: Endovascular management of traumatic STA pseudoaneurysms allows lesion-specific, angiography-guided strategies, including intrasaccular aneurysm exclusion with preservation of the STA trunk and branches, or selective occlusion of the involved branch while maintaining flow in uninvolved arterial segments, resulting in durable clinical resolution at mid-term follow-up.
Singh et al. (Fri,) studied this question.