Common carotid artery pseudoaneurysm

Common carotid artery (CCA) pseudoaneurysm is usually discovered as pulsate neck mass. The neurological deficit due to compression of the nerve can also be seen. The intracranial occlusion or intracranial embolus can occur due to thrombus. This may lead to rupture; the results of which can be fatal, so immediate treatment is necessary 1)


Nomura et al. reported a case of extracranial common carotid artery pseudoaneurysm (pseudo-ECAA) with a rare clinical course and pathological features. A 58-year-old man presented with swelling and purpura on the left side of his neck after sneezing. Radiological examinations suggested a ruptured left common carotid artery aneurysm. The operative findings were consistent with a pseudoaneurysm. Pathological examination revealed disarrangement and degeneration of smooth muscle fibers in the media, in addition to scattered foci of mucoid accumulation and irregular-shaped cavitation in the medial extracellular matrix, raising the possibility of an intrinsic dysfunction of the vascular wall in the pathological process of pseudoaneurysm formation 2).


1)
A. N. Keeling, F. P. McGrath, and M. J. Lee, “Interventional radiology in the diagnosis, management, and follow-up of pseudoaneurysms,” CardioVascular and Interventional Radiology, vol. 32, no. 1, pp. 2–18, 2009.
2)
Nomura S, Yoneyama T, Kawashima A, Yamaguchi K, Ishikawa T, Okada Y, Shibata N, Kawamata T. A case of idiopathic extracranial carotid artery pseudoaneurysm with a rare clinical course and pathological features. Neuropathology. 2021 Feb 1. doi: 10.1111/neup.12719. Epub ahead of print. PMID: 33525054.
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