Dissecting Aneurysm of the Anterior Temporal Artery: A Rare Case Report and Literature Review

Abstract

Dissecting aneurysm located at the trunk of the anterior temporal artery (ATA) is an extremely rare entity of which only a few cases have ever been reported. As a result of the small caliber and supposed non-competency of the ATA, sacrificing of the artery distal to the aneurysm is the mainstay of treatment. In this report, we present a 28-year-old man who was admitted for a ruptured fusiform aneurysm of the left ATA. He underwent resection of the aneurysm combined with superficial temporal artery (STA)-ATA anastomosis. Histopathological study showed that the aneurysm was compliant with an artery dissection. The postoperative process was unremarkable and he was discharged with no neurological deficit. Follow-up angiography showed the anastomosis was patent. ATA is considered a non-competent intracranial artery. Although recently some investigators have conducted cadaveric studies using the ATA as a donor vessel for intracranial-intracranial (IC-IC) bypass, clinical consequences of ATA occlusion have not been reported yet. The supposed safety of ligation of ATA for IC-IC bypass was based on the fact that the anterior temporal lobectomy for temporal lobe epilepsy does not lead to major neurological deficits. This extrapolation could not be arbitrarily used in ATA occlusion for IC-IC bypass. STA-ATA anastomosis is a reasonable option in case of the ATA dissecting aneurysm.

Keywords

anterior temporal artery - superficial temporal artery - intracranial aneurysm - intracranial-intracranial bypass

Disclosures

The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper.

Consent

Written informed consent was obtained from the patient for publication of this manuscript and any accompanying images. Copy of the written consent is available for review with the Editor of this journal.

^* These are first co-authors.

Publication History

Received: 05 August 2019

Accepted: 02 December 2019

Article published online:
01 December 2020

• References

• 1 Meybodi AT, Lawton MT, Griswold D. et al. Anterior Temporal Artery-to-Anterior Cerebral Artery Bypass: Anatomic Feasibility of a Novel Intracranial-Intracranial Revascularization Technique. World Neurosurg 2017; 99: 667-673
• 2 Tayebi Meybodi A, Lawton MT, Griswold D, Mokhtari P, Payman A, Benet A. The anterior temporal artery: an underutilized but robust donor for revascularization of the distal middle cerebral artery. J Neurosurg 2017; 127 (04) 740-747
• 3 Yağmurlu K, Kalani MYS, Chaddad-Neto F. et al. Anterior temporal artery to posterior cerebral artery bypass for revascularization of the posterior circulation: An anatomical study. J Clin Neurosci 2018; 47: 337-340
• 4 Pabaney AH, Mazaris PA, Kole MK, Reinard KA. Endovascular management of fusiform aneurysm of anterior temporal artery: Technical report. Surg Neurol Int 2015; 6: 119
• 5 Umeoka K, Shirokane K, Mizunari T, Kobayashi S, Teramoto A. Dissecting aneurysm of the anterior temporal artery: case report. Neurol Med Chir (Tokyo) 2011; 51 (11) 777-780
• 6 Saito A, Fujimura M, Inoue T, Shimizu H, Tominaga T. Lectin-like oxidized low-density lipoprotein receptor 1 and matrix metalloproteinase expression in ruptured and unruptured multiple dissections of distal middle cerebral artery: case report. Acta Neurochir (Wien) 2010; 152 (07) 1235-1240
• 7 Seo BR, Pil Joo S, Kim TS. Pitfall of CT angiography for an aneurysm around middle cerebral artery bifurcation. Br J Neurosurg 2009; 23 (02) 209-210
• 8 Kim IY, Kim TS, Lee JH, Lee MC, Lee JK, Jung S. Inflammatory aneurysm due to neurocysticercosis. J Clin Neurosci 2005; 12 (05) 585-588
• 9 Asakura K, Tasaki T, Okada K. [A case of unruptured anterior temporal artery aneurysm showing pupil-sparing oculomotor palsy]. No Shinkei Geka 1986; 14 (06) 777-782
• 10 McClelland III S, Guo H, Okuyemi KS. Population-based analysis of morbidity and mortality following surgery for intractable temporal lobe epilepsy in the United States. Arch Neurol 2011; 68 (06) 725-729