title: Unusual angiographic changes in an internal carotid artery pseudoaneurysm after infection in the deep neck space.
abstract: A 48-year-old man presented with a pseudoaneurysm at the cervical portion of the left internal carotid artery (ICA) secondary to infection in the deep neck space. Magnetic resonance (MR) imaging demonstrated enhancement of the wall of the ICA and a pseudoaneurysm, considered to be sequelae of infection spread. ICA occlusion occurred on the next day resulting in sudden onset of right hemiparesis and motor aphasia. The ICA pseudoaneurysm shrank gradually and his neurological deficits improved with conservative therapy. One month later, he presented with aneurysm regrowth. The common carotid artery was occluded with Guglielmi detachable coils to block arterial flow into the pseudoaneurysm. There were no neurological complications. Marked enhancement of the ICA wall on computed tomography and MR imaging may indicate the possibility of vascular complications such as rupture, pseudoaneurysm development, or ICA occlusion, and consequent neurological deficits. ICA occlusion caused by spread of infection in the deep neck space may cause accelerated coagulopathy due to ICA wall inflammation.
authors.affiliation: Department of Neurosurgery, Graduate School of Medical Science, Kanazawa University, Ishikawa, Japan. yahayashi@ns.m.kanazawa-u.ac.jp
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Hayashi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Shima
authors.forename: Katsuyoshi
authors.initials: K
authors.lastname: Miyashita
authors.forename: Masashi
authors.initials: M
authors.lastname: Kinoshita
authors.forename: Mitsutoshi
authors.initials: M
authors.lastname: Nakada
authors.forename: Shinya
authors.initials: S
authors.lastname: Kida
authors.forename: Jun-ichiro
authors.initials: J
authors.lastname: Hamada
mesh_terms: D017541:Aneurysm, False / Q000000981:diagnostic imaging* / Q000209:etiology / Q000628:therapy; D000792:Angiography; D002343:Carotid Artery, Internal; D006801:Humans; D008297:Male; D008875:Middle Aged; D009333:Neck; D018461:Soft Tissue Infections / Q000150:complications / Q000175:diagnosis / Q000628:therapy