title: Unusual aneurysms of the extracranial carotid artery.
abstract: Aneurysms of the extracranial internal carotid artery are rare and only 4 cases have been treated at the Wellesley Hospital since 1969. These aneurysms usually present as a painless lump in the neck and the 4 cases to be described manifest unusual presentations. One patient with a history of facial sepsis presented in the Emergency Department with what was thought to be a neck abscess. This was incised and drained before the true nature of the swelling was appreciated. Two patients presented with nerve palsies, one with a hypoglossal palsy due to stretching of the hypoglossal nerve over a large aneurysm and the second with recurrent laryngeal nerve palsy as a result of rupture of a false aneurysm from disruption of a saphenous vein patch inserted following carotid endarterectomy 9 months earlier. The fourth patient presented with a carotid bruit and had a stenosis distal to the aneurysm. Although rare, carotid aneurysms require recognition and early treatment if neurological sequelae are to be avoided.
mesh_terms: D000328:Adult; D000368:Aged; D000783:Aneurysm / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D000785:Aneurysm, Infected / Q000209:etiology; D000792:Angiography; D001161:Arteriosclerosis / Q000150:complications; D001424:Bacterial Infections / Q000150:complications; D002340:Carotid Artery Diseases / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D004691:Endarterectomy / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012886:Skull