Aneurysm of the Extracranial Internal Carotid Artery Seven Years After Trauma: A Case History and Literature Review

Abstract

A false aneurysm of the extracranial internal carotid artery developed seven years after the effects of a motorcar accident had been treated in the Department of Otolaryngology. Excision and reconstructive surgery were successfully performed in the Division of Vascular Surgery.Literature study shows aneurysms of the extracranial carotid artery to be a rare condition. Trauma is mentioned as a major cause. Active treatment is mandatory. Surgical resection and reconstruction should be preferred. Case HistoryA sixty-two-year-old Caucasian male was directed to our division by the ENT department in September, 1987, presenting with a pulsatile mass in the left lateral neck region. This proved to be a sessile aneurysm at the origin of the internal carotid artery (Fig. 1). The patient's history was irrelevant, except for the fact that he had sustained a motorcar accident seven years before. During the crash he was forcefully projected to the left and his lateral neck region hit badly against his safety belt. He had had no other significant injuries. Surgery was undertaken on September 17, 1987. The carotid bifurcation was macroscopically normal, except for large, 2-3 cm, very thin-walled aneurysm (Fig. 2). It was excised and the defect was closed with a saphenous vein patch. Microscopic studies of the specimen were compatible with a false aneurysm.The postoperative course was uneventful. There was no neurologic deficit and control digital subtraction angiography showed an almost normal shape of the artery (Fig. 3).