A case report of superficial temporal artery aneurysm associated with acupressure massage

Background: Superficial temporal artery (STA) aneurysms are rare vascular lesions and are most commonly associated with traumatic events. We present a case of a main trunk STA aneurysm in a patient with a history of repetitive minor mechanical stress in the form of self-administered acupressure massage, successfully treated with endovascular treatment. We also provide a focused review of previously reported main trunk STA aneurysms to further characterize clinical features and management considerations. Case Description: A 53-year-old man presented with a pulsatile mass in the right preauricular region. He had routinely performed self-administered acupressure massage to this area. Imaging studies revealed an approximately 9-mm aneurysm arising from the main trunk of the right STA. Angiography demonstrated gradual enlargement of the aneurysm and irregularity of the surrounding arterial wall, with the proximal dissected segment located posterior to the aneurysm near the zygomatic arch. Given the anatomical location of the aneurysm and the associated risk of nerve injury, endovascular treatment was selected. Coil embolization including both the aneurysm and the proximal dissected segment was performed. The postoperative course was uneventful, and no recurrence was observed during follow-up. Conclusion: This case suggests that minor mechanical stress may contribute to the development of a main trunk STA aneurysm. Although surgical ligation remains the commonly reported treatment, endovascular treatment may be considered a feasible option in selected cases, particularly when anatomical considerations favor a minimally invasive approach.