Symptomatic Carotid Artery Pseudoaneurysm 28 Years After Neck Trauma

Abstract

This is a case report of a 63-year-old man who presented with a pseudoaneurysm of the left common carotid artery following a previous neck injury. The pseudoaneurysm was discovered incidentally during a routine Doppler ultrasound of the neck after the patient suffered a stroke with right-sided hemiparesis and dysphasia. A multi-detector computed tomography angiography scan showed a 25-mm pseudoaneurysm with a partial thrombus in the lumen, originating from the left common carotid artery. The patient underwent open surgery with reconstruction done by the interposition of a prosthetic graft between the common and internal carotid arteries. The postoperative course was uneventful, and the patient was discharged on the third postoperative day. The rarity of extracranial carotid artery pseudoaneurysms and their potential to cause serious complications such as stroke and rupture underscores the need for prompt diagnosis and management. The question of the best treatment remains controversial, and there are no studies that directly compare the success of open surgery and endovascular treatment of extracranial carotid artery pseudoaneurysm. Regular ultrasound monitoring should be performed in patients with confirmed neck trauma and/or operations to detect any delayed onset of carotid pseudoaneurysms. © Association of Surgeons of India 2023.