Facial artery pseudoaneurysm without evidence of trauma

Abstract

False aneurysm or pseudoaneurysm is usually a result of blunt trauma causing laceration of part of the vessel wall and extravasation of blood into surrounding tissue, followed by tamponade and clot formation. The wall of the pseudoaneurysm consists of perivascular fibrous tissue. Extracranial carotid artery pseudoaneurysms are relatively rare because trauma to external carotid artery branches usually results in total transection rather then partial laceration of blood vessel. Most affected branches are the superficial temporal artery, internal maxillary artery and distal facial artery, usually where they pass over the bone (zygoma or mandible). The authors present the case of a 78-year-old male patient with facial artery pseudoaneurysm in its proximal part in the submandibular region with no known evidence of trauma. To the authors' knowledge this is the first case in the literature of facial artery pseudoaneurysm without traumatic origin and the third case of proximal facial artery pseudoaneurysm. Although formation of pseudoaneurysm in the region of face and neck is rare, the authors consider that inclusion of pseudoaneurysm in the differential diagnosis of a neck mass is important.