Giant Extracranial Internal Carotid Artery Aneurysm: A Rare Presentation with an Oropharyngeal Mass

Abstract

Aneurysms of the extracranial carotid arteries are infrequent lesions in both neurosurgery and cardiovascular surgery practice. Although the exact frequency is unclear, it has been reported in 1 of 60 to 1 of 800 of all aneurysms found at the other anatomic locations and in less than 1% of surgical procedures performed for carotid artery diseases. 1 Most of these aneurysms are believed to be the result of either traumatic or spontaneous dissections. Along with showing the outcome of these lesions, clinical and angiographic presentations show significant variations according to the etiology. 2,3 Traumatic aneurysms usually tend to manifest at the time of insult, or a few months after the insult, but occasionally show a prolonged history, whereas spontaneous lesions usually remain silent for years. Spontaneous dissections frequently affect the proximal segment of the internal carotid artery (ICA) and the bifurcation of the common carotid artery (CCA). 2 Bilateral involvement of the carotid system is not an infrequent event and suggests an underlying atherosclerotic disease, fibromuscular dysplasia, or other connective tissue disorders. The clinical manifestation of these lesions may vary from the serious ischemic deficits and lower cranial nerve palsies to an asymptomatic mass in the neck or a prolonged history of headache.