Traumatic arteriovenous fistula of the superficial temporal artery

Traumatic arteriovenous fistula (AVF) of the superficial temporal artery (STA) is rare. We report a case of surgically treated, histopathologically confirmed traumatic AVF of the STA. A 24-year-old male was admitted to our hospital after a traffic accident. Computed tomography scan on admission showed an acute epidural hematoma on the right surface of frontal lobe, which was emergently treated by surgical evacuation. One month later, he was aware of pulsatile tinnitus around the left ear. Digital subtraction angiogram showed an AVF, mainly fed by the left STA. After total removal of the fistula, his tinnitus immediately disappeared. Histopathological examination demonstrated that the artery was connected to the vein through the thin-walled vessels lacking internal elastic lamina and muscularized media, suggesting that the connecting vessels were newly formed.