Carotid Artery Pseudo-Aneurysm

Excerpt

To the Editor: A 10-mo-old infant presented with swelling on the left side of the neck for 3 mo, prior to visit to our hospital. Ultrasonography at outside hospital was suggestive of thick walled cystic lesion (suspected suppurative lymphadenitis). Subsequently, a blind needle aspiration of the lesion was performed in an other hospital. However, post needle aspiration, due to rapid increase in size and presence of signs of inflammation the case was referred to us. At presentation, it was a pulsatile mass with excoriation and oozing of the skin over it. Suspecting aneurysmal swelling, magnetic resonance angiography was done which revealed giant left sided pseudoaneurysm with origin from bifurcation of left common carotid artery (CCA). Digital subtraction angiography revealed no flow from the opposite side through circle of Willis. Coil embolisation of the aneurysmal neck was unsuccessful. Meanwhile, aneurysm ruptured spontaneously mandating emergency ligation. Post operatively, child was monitored in ICU for 4 d in post-operative period and discharged subsequently without any neuro-deficit. …