title: Vernet's syndrome caused by large mycotic aneurysm of the extracranial internal carotid artery after acute otitis media--case report.
abstract: An 85-year-old man presented with a rare large aneurysm of the extracranial internal carotid artery (ICA) due to acute otitis media manifesting as Vernet's syndrome 2 weeks after the diagnosis of right acute otitis media. Angiography of the right extracranial ICA demonstrated an irregularly shaped large aneurysm with partial thrombosis. The aneurysm was treated by proximal ICA occlusion using endovascular coils. The ICA mycotic aneurysm was triggered by acute otitis media, and induced Vernet's syndrome as a result of direct compression to the jugular foramen. Extracranial ICA aneurysms due to focal infection should be considered in the differential diagnosis of lower cranial nerve palsy, although the incidence is thought to be very low.
authors.affiliation: Department of General Medicine, Ibaraki Prefectural Central Hospital, Kasama, Ibaraki, Japan.
authors.forename: Mizuki
authors.initials: M
authors.lastname: Amano
authors.forename: Eiichi
authors.initials: E
authors.lastname: Ishikawa
authors.forename: Yuji
authors.initials: Y
authors.lastname: Kujiraoka
authors.forename: Shunji
authors.initials: S
authors.lastname: Watanabe
authors.forename: Kei
authors.initials: K
authors.lastname: Ashizawa
authors.forename: Eiichi
authors.initials: E
authors.lastname: Oguni
authors.forename: Atsushi
authors.initials: A
authors.lastname: Saito
authors.forename: Yasunobu
authors.initials: Y
authors.lastname: Nakai
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Ikeda
authors.forename: Takashi
authors.initials: T
authors.lastname: Abe
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Uekusa
authors.forename: Akira
authors.initials: A
authors.lastname: Matsumura
mesh_terms: D000055:Accessory Nerve / Q000503:physiopathology; D061227:Accessory Nerve Injuries; D000208:Acute Disease / Q000628:therapy; D000369:Aged, 80 and over; D015901:Angiography, Digital Subtraction; D002343:Carotid Artery, Internal / Q000382:microbiology / Q000473:pathology; D020215:Carotid Artery, Internal, Dissection / Q000000981:diagnostic imaging / Q000382:microbiology* / Q000473:pathology*; D003244:Consciousness Disorders / Q000209:etiology; D003389:Cranial Nerve Diseases / Q000209:etiology / Q000503:physiopathology; D004244:Dizziness / Q000209:etiology; D004432:Ear, Middle / Q000382:microbiology / Q000473:pathology / Q000503:physiopathology; D004621:Embolization, Therapeutic / Q000295:instrumentation / Q000379:methods; D005334:Fever / Q000382:microbiology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009181:Mycoses / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology*; D010033:Otitis Media / Q000150:complications* / Q000382:microbiology* / Q000503:physiopathology; D010034:Otitis Media with Effusion / Q000382:microbiology / Q000473:pathology / Q000503:physiopathology; D019919:Prosthesis Implantation / Q000379:methods; D019291:Skull Base / Q000000981:diagnostic imaging / Q000473:pathology; D013577:Syndrome; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014630:Vagus Nerve / Q000503:physiopathology; D061223:Vagus Nerve Injuries