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A woman in her mid-80s presented to the emergency department because of progressive increase in volume of a subcutaneous frontal hematoma (Figure 1). This hematoma had initially appeared 6 weeks earlier, following a fall resulting in direct facial trauma.
An ultrasound was performed and showed a 1.5-cm anechoic formation within the hematoma, in contact with a frontal branch of the superficial temporal artery (STA). This lesion was pulsatile, with blood flow circulating in it ("Yin-Yang" sign) and corresponded to a false aneurysm (Figure 2A–C). She was successfully treated by selective embolization of the supplying artery (Figure 2D).
False aneurysm (or pseudoaneurysm) occurs after localized rupture of the vascular wall. It consists of a pocket of blood communicating with the injured vessel, contained by the adjacent tissues.
Doppler ultrasound is the first-line examination to confirm the diagnosis. Computed tomography and magnetic resonance imaging can also be useful. Angiography is an invasive examination and should be performed for therapeutic purposes.