title: Spontaneous internal carotid artery rupture during neck dissection in osteogenesis imperfecta patient.
abstract: OBJECTIVE
  Several connective tissue disorders are associated with vascular wall abnormalities, including spontaneous dissection of the cervical arteries. Osteogenesis imperfecta (OI) is a hereditary disorder, with rare neurovascular complications, which potentially lead to life-threatening events.
  
  
  METHODS
  We presented a case of spontaneous internal carotid artery (ICA) rupture that occurred in a 52-year-old-woman, suffering from OI type I, and who underwent a bilateral modified radical neck dissection (mRND) plus total thyroidectomy for a T4aN1b thyroid cancer. During mRND, an ICA's spontaneous rupture occurred.
  
  
  RESULTS
  Histopathologic report suggested a structural defect of the arterial wall without cancer infiltration. The patient did not experience any neurologic complications.
  
  
  CONCLUSIONS
  Head and neck surgeons have to be aware about early clinical recognition of possible cervical vascular abnormalities, in patients with connective tissue disorders, potentially responsible for dramatic vascular rupture during cervical surgical procedures.
authors.affiliation: First Clinic of Otolaryngology, Department of Surgery and Translational Medicine, University of Florence, Via Largo Brambilla 3, 50134 Florence, Italy. Electronic address: mannelli.giuditta@gmail.com.
authors.forename: Giuditta
authors.initials: G
authors.lastname: Mannelli
authors.affiliation: First Clinic of Otolaryngology, Department of Surgery and Translational Medicine, University of Florence, Via Largo Brambilla 3, 50134 Florence, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Deganello
authors.affiliation: First Clinic of Otolaryngology, Department of Surgery and Translational Medicine, University of Florence, Via Largo Brambilla 3, 50134 Florence, Italy.
authors.forename: Maria Rosa
authors.initials: MR
authors.lastname: Laganà
authors.affiliation: First Clinic of Otolaryngology, Department of Surgery and Translational Medicine, University of Florence, Via Largo Brambilla 3, 50134 Florence, Italy.
authors.forename: Oreste
authors.initials: O
authors.lastname: Gallo
mesh_terms: D002291:Carcinoma, Papillary / Q000601:surgery; D002343:Carotid Artery, Internal / Q000473:pathology*; D005260:Female; D006801:Humans; D007431:Intraoperative Complications; D008875:Middle Aged; D037981:Neck Dissection; D010013:Osteogenesis Imperfecta / Q000150:complications*; D012422:Rupture, Spontaneous / Q000209:etiology; D013964:Thyroid Neoplasms / Q000601:surgery
keywords: Connective tissue disorder; Major cervical vessel rupture; Osteogenesis imperfecta; Spontaneous rupture of ICA; Weakness of the vessel wall