Self-Resolving Pulsatile Frontal Mass Following Blunt Head Trauma

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Case Presentation

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A 58-year-old man was hospitalized following a traffic accident involving a light truck. He arrived febrile, SARS-CoV-2 antigen positive, and conscious without neurologic signs. Computed tomography of the head revealed traumatic subarachnoid hemorrhage, basilar skull fracture with pneumocephalus, left periorbital and zygomatic fractures, and multiple left rib fractures. Contrast-enhanced computed tomography showed a right frontal subcutaneous hemorrhage and a 9 mm pseudoaneurysm in the periphery of the frontal branch of the right superficial temporal artery (STA) without an adjacent convexity fracture (Fig A,B). He was admitted for blood pressure regulation, pain management, cerebral monitoring, and rehabilitation.FigureA, Contrast-enhanced computed tomography scan revealing a right frontal subcutaneous hemorrhage with a 9 mm pseudoaneurysm. B, Computed tomography angiography demonstrating a 9 mm pseudoaneurysm at the periphery of the frontal branch of the right superficial temporal artery. C and D, Clinical image of a pulsatile mass that appeared in the right frontal area on the day following admission.

Diagnosis: Traumatic Superficial Temporal Artery Pseudoaneurysm

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The next day, a pulsatile mass appeared in the right frontal area (Fig C,D), not necessitating surgical intervention during the hospital stay. He was discharged on day 17, and his 2-week follow-up showed that the mass was pulseless and had resolved without surgery. Although the spontaneous resolution of a traumatic STA pseudoaneurysm has been reported following long-term observation, the gold standard is still considered to be surgical or radiologic intervention.1, 2, 3, 4 A rapidly developing closed-traumatic pseudoaneurysm in the periphery of the STA can resolve spontaneously, as demonstrated in our case.

Funding and Support

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Conflict of Interest

All authors have affirmed they have no conflicts of interest to declare.