title: Internal Carotid Artery Pseudoaneurysm and Ischemic Stroke Secondary to Retropharyngeal and Parapharyngeal Abscess.
abstract: Internal carotid artery pseudoaneurysm is an uncommon complication of retropharyngeal and parapharyngeal abscess in children. Treatment of the pseudoaneurysm has evolved in recent years from surgical ligation to endovascular techniques. Neurologic sequelae most commonly consist of Horner's syndrome with cerebral ischemia being uncommon. The clinical course of a 2-year-old boy with retropharyngeal abscess complicated by internal carotid artery pseudoaneurysm, is described and the literature is reviewed. A conventional angiogram confirmed the presence of a large pseudoaneurysm with no anterograde flow distal to the pseudoaneurysm and substantial collateral flow across the circle of Willis, with filling of the left anterior and middle cerebral arteries via the anterior and posterior communicating arteries. Endovascular occlusion resulted in nonfilling of the left internal carotid artery, pseudoaneurysm, and left internal jugular vein at the base of the skull. Following the procedure, the patient developed transient mild right hemiparesis associated with frontal lobe ischemia.
authors.affiliation: 1 Department of Neurology, Mayo Clinic, Rochester, MN, USA.
authors.forename: Michael W
authors.initials: MW
authors.lastname: Ruff
authors.affiliation: 1 Department of Neurology, Mayo Clinic, Rochester, MN, USA.
authors.forename: Deena M
authors.initials: DM
authors.lastname: Nasr
authors.affiliation: 1 Department of Neurology, Mayo Clinic, Rochester, MN, USA.
authors.forename: James P
authors.initials: JP
authors.lastname: Klaas
authors.affiliation: 1 Department of Neurology, Mayo Clinic, Rochester, MN, USA.|2 Department of Pediatrics, Mayo Clinic, Rochester, MN, USA.
authors.forename: Deborah L
authors.initials: DL
authors.lastname: Renaud
mesh_terms: D017541:Aneurysm, False / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging; D002675:Child, Preschool; D006801:Humans; D008297:Male; D017703:Retropharyngeal Abscess / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy; D020521:Stroke / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy
keywords: acute ischemic stroke; endovascular coiling; internal carotid artery; pseudoaneurysm; retropharyngeal abscess