The most common presentation of a pseudoaneurysm of the superficial temporal artery is from trauma as a pulsatile cystic lesion in the region of the temple, which tends to enlarge steadily, accompanied by a persistent throbbing headache. Histologically they are dissimilar from true aneurysms as they do not contain all three layers of the arterial wall and 95% of these lesions are traumatic in origin. Diagnosis of the lesion can be made by duplex ultrasound scan, ultrasound and CT, CT scan with contrast and angiography. Treatment of this lesion varies within institutions but most commonly a complete excision is preferred with ligation of the proximal and distal vessels, which provides a better cosmetic result.
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Competing interests: None declared.
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