Traumatic aneurysm of the common carotid artery

Extracranial carotid artery aneurysm

Although rare, extracranial carotid aneurysms are common enough to be considered in the differential diagnosis of a mass in the neck or posterior pharynx. The unexpected finding of an aneurysm of the carotid artery during the biopsy of a mass in the neck for histologic diagnosis could be catastrophic. The case presented demonstrates the importance of diagnostic imaging of the neck prior to biopsy of a clinically presumed solid mass.

Closed cervicocranial trauma, "false aneurysm" of the internal carotid artery and brain infarction

A 17-year-old man developed acute hemiparesis 6 months after a motor cycle accident. In the accident he had a closed trauma on the contralateral side of the head and the neck, with multiple bone fractures. Aortocervical angiography, performed after the infarction, revealed a 2.5 cm long aneurysmatic dilatation in the internal carotid artery, the presumably source of embolic infarction. This and the 24 other cases gathered from the literature support the notion that closed neck trauma may create "false aneurysm" which again may cause neurological deficits.

Traumatic rupture of the cervical carotid arteries: an autopsy and histopathological study of 200 cases

Over the 19-month period November 7th, 1984 to June 11th, 1986, 200 consecutive autopsies were conducted on victims of motor vehicle accidents. In each case, both common carotid arteries and their respective internal and external branches up to 2 cm beyond the bifurcation were examined for evidence of contusion, partial tearing or rupture. All lacerations or disruptions were excised together with a segment of surrounding arterial tissue, and processed, sectioned and examined by conventional light microscopy for the presence and extent of arterial tears. Several findings emerged: (i) in nearly one-third of subjects there was some degree of arterial disruption; (ii) dual or even triple vessel involvement in both an ipsilateral and contralateral distribution occurred in 38.6% of the 57 subjects in whom traumatic arterial lesions were found; (iii) the large number of intimal disruptions encountered, 44.7% of which showed extension of the tear to the internal elastic lamina with further longitudinal continuation of the tear along the lamina without breaching it; (iv) tears along the laminar planes of the media occurred in 52.6% of the 57 subjects and was particularly apparent at sites of subsidiary vessel bifurcation; (v) compound intimo-medial tears occurred in almost two-thirds (63.2%) of the 57 subjects, highlighting the dual involvement of these layers of the arterial wall in traumatic lesions; (vi) the occurrence of adventitial contusions in 70.2% of the 57 subjects; (vii) the occurrence of complete vessel wall transection in more than one-quarter (26.3%) of the vessels with positive findings and involving nearly one-third (31.6%) of subjects, indicating perhaps the severity of the trauma to which the victims were exposed.