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CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2013; 23(03): 208-211
DOI: 10.4103/0971-3026.120264
Head and Neck Radiology

Pseudoaneurysm of internal carotid artery after carotid body tumor excision

Ananathakrishnan Ramesh
Department of Radiodiagnosis, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
,
Rajakannu Muthukumarassamy
Department of Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
,
Vilvapathy Senguttuvan Karthikeyan
Department of General Surgery, Sri Venkateshwaraa Medical College Hospital and Research Centre, Puducherry, India
,
Govindasamy Rajaraman
Department of Neurosurgery, Indira Gandhi Government General Hospital, Puducherry, India
,
Sandeep Mishra
Department of Anesthesiology and Critical Care, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
› Author Affiliations Financial support and sponsorship Nil.
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Abstract

The common causes of pseudoaneurysms of internal carotid artery (ICA) in the neck are penetrating trauma, head and neck surgeries, carotid endarterectomies, infiltrating metastatic lymph nodes and neoplasms. We report a young male patient who presented with a swelling in left upper neck diagnosed as carotid body tumor with ultrasonography and magnetic resonance imaging. Subadventitial excision of the tumor was done. The patient developed dense right hemiplegia in the immediate postoperative period. Doppler study of neck revealed left ICA dissection with partial thrombosis of the lumen. Computed tomography of the brain revealed nonhemorrhagic left capsuloganglionic infarct and he was managed conservatively with heparin. Follow-up Doppler study done 2 weeks later revealed pseudoaneurysm of the ICA. Attempts to obliterate the pseudoaneurysm by interventional procedures failed due to the narrow neck of the pseudoaneurysm. Heparin was stopped and patient was maintained only on oral aspirin. Doppler study repeated 1 week later showed spontaneous thrombosis of the pseudoaneurysm with good flow in the distal ICA. To the best of our knowledge, only one case of pseudo-pseudoaneurysm complicating surgical resection of carotid body tumor has been reported so far The etiology, imaging features, and treatment options of pseudoaneurysms are discussed.

Keywords

Capsuloganglionic infarct - carotid body tumor - color Doppler - dissection - excision - internal carotid artery - magnetic resonance imaging - pseudoaneurysm


Publication History

Article published online:
30 July 2021

© 2013. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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