Temporal arteries

EC-IC arterial bypass involves the use of general anesthesia, open craniotomy, and end-to-side anastomosis of the superficial temporal artery to a branch of the middle cerebral artery (MCA) (Fig. 6.1). Currently, this technique is being used primarily in the setting of intracranial aneurysm therapy, moyamoya disease, and... 

FIGURE 6.1 CT angiography of an EC-IC bypass, showing the new intracranial course of the right superficial temporal artery, anastamosed to the middle cerebral artery M2 segment. 

Q77 Giant cell arteritis may present with tender and non-pulsatile temporal arteries together with erythema and oedema of the overlying skin. The condition may require the use of prednisolone tablets for at least 2 years. 

Giant cell arteritis (cranial or temporal arteritis) is an inflammatory condition that may affect any of the large arteries, especially the temporal and occipital arteries. The thickened temporal arteries may be tender and non-pulsatile, with erythema and oedema of the overlying skin. Early treatment with high-dose corticosteroids such as prednisolone is essential and should be continued for a minimum of 2-3 years at a reduced dose. 

Takayasu arteritis affects medium-sized and large arteries, specifically the aorta and the supraaortic branches. The disease is usually not seen in intracranial vessels nor in the temporal artery. Although for a long time DSA was accepted as a diagnostic... 

Early development of intimal thickening in superficial temporal arteries in patients with Moyamoya disease. Stroke 27 1750-1754... 

Temporal artery biopsy may be required in suspected temporal arteritis (Ch. 6). 

Moyamoya syndrome (Ch. 6) causes gradual stenosis or occlusion of the terminal portions of the internal carotid arteries or middle cerebral arteries. This leads to formation of an abnormal collateral network of fragile vessels, which occasionally rupture. It has been proposed that constructing a bypass to relieve the pressure on the collaterals would be beneficial, for example between the superficial temporal artery and the middle cerebral... 

PULSATILES — Temporal Artery the Pulse Arterial Veins. 

Temporal arteritis is inflammation of the temporal artery running down the side of the head just in front of the ear. It occurs almost exclusively in elderly people. There is severe unilateral pain, and the area of the temple is inflamed and tender to the touch. There may be associated jaw pain and generalised rheumatic pains. Refer immediately to a doctor. 

Dr. Farr recommended a trial of H202 therapy, because peroxide had proven of value in many inflammatory processes such as pneumonia and asthma. Temporal arteritis is an inflammation of the temporal artery, so, he reasoned, H202 should be of value. 

Head Soft tissue injury Tender, thickened, or pulseless temporal artery Obliteration of flow through the trochlear artery with compression of the preauricular or supraorbital vessels Anhidrosis Tongue laceration Head trauma Temporal arteritis ICA occlusion or severe stenosis with retrograde ophthalmic flow CCA dissection with damage to sympathetic fibers or brainstem stroke with interruption of sympathetic tract Consider seizure as the cause of the neurologic deterioration... 

Nervous system The headache eliciting effect of prostacyclin (PGI2) has been studied in 12 healthy subjects in a double-blind, crossover, study [30, in which epoprostenol 10 nanograms/kg/minute was infused for 25 minutes. During the immediate phase (0-30 minutes) and the post-infusion phase (30-90 minutes) 11 subjects reported headache after epoprostenol and none reported headache on the placebo day. The headache was associated with dilatation of the superficial temporal artery but there was no dilatation of the middle cerebral artery. These data suggest that PGl2-induced headache may be due to activation and sensitization of sensory afferents around extracranial arteries. 

Fig. 18.3. Final appearance of the external carotid artery. 1, occipital artery 2, ascending pharyngeal artery 3, inferior tympanic artery 4, internal carotid artery 5, lingual artery 6, facial artery 7, posterior auricular artery 8, superficial temporal artery 9, petrous branch 10, middle meningeal artery 11, maxillary artery 12, transverse facial artery...

There are multiple anastomoses between the intraorbital branches with the external carotid system only supplying the periorbital region. This includes the internal maxillary, superficial temporal arteries and the facial system. 

Fig. 18.8a-d. Selective occipital angiogram in lateral view a demonstrates high-flow scalp AVM which was also supplied by branches of the ipsilateral and contralateral superficial temporal arteries and contralateral occipital artery (not shown). Following transarterial partial embolization with glue and particles of PVA into these vessels a percutaneous approach was performed b,c with injection of glue (50% NBCA/ 50% Lipiodol) resulting in complete obliteration of the AVM nidus as shown on the post embolization left external carotid angiogram d... 

L.V. Kucherenko, Efficacy of infusion therapy via superficial temporal artery in eye diseases. Synopsis of the scientific work for the degree of the degree of medical doctor [Odessa, Ukraine],(1991). 

While injection of 5HT in the area of the superficial temporal artery was found in one study [438] to induce headache in... 

The lateral branches of the M-1 segment are now studied carefully the temporopolar, anterior temporal and middle temporal arteries are identified (sometimes all three, but particularly the middle temporal artery, may arise from the M-2 segment). 

An incision 1 -2 cm in length is made, lateral to M-1 and anteromedial to M-2, into the inferior insulae sulcus opening the anterior portion of the uncinate fasciculus. The incision is placed where the perforating branches to the insula have been coagulated and lies between the temporopolar and anterior temporal arteries. The amygdala is found some few mm in depth from the cortical surface. 

Variations are frequently encountered in the form and distribution of the lateral branches of the M-1 segment. The surgeon must find, or by mobilization create, sufficient space to make a 2 cm incision between the two temporal arteries. 

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