Gralla Jan, Brekenfeld Caspar, Schmidli Juerg, Caversaccio Marco, Do Dai-Do, Schroth Gerhard
Department of Neuroradiology, University of Bern, Switzerland.
J Endovasc Ther. 2004 Dec;11(6):734-8. doi: 10.1583/1308R.1.
To describe the management of a pediatric patient with recurrent, life-threatening nasopharyngeal hemorrhages due to a pseudoaneurysm of the internal carotid artery (ICA), most likely caused by deep neck infection following peritonsillar abscess.
An 11-year-old boy presented with lymphadenopathy of the neck, torticollis, and difficulty swallowing that had persisted for some weeks. After sneezing, the patient suffered massive recurrent nasopharyngeal hemorrhages leading to anemia. Computed tomography identified a 2 x 2-cm hematoma in the left parapharyngeal space; angiography revealed a saccular aneurysm (14.1 x 8.2 mm) of the extracranial ICA adjacent to the skull base, without ongoing hemorrhage. A bare Wallstent was initially implanted, but total exclusion was achieved only after secondary placement of a Symbiot covered stent within the bare stent.
This case demonstrates the utility of an endovascular approach to an extracranial ICA pseudoaneurysm in a pediatric patient.
描述一名儿科患者因颈内动脉（ICA）假性动脉瘤导致反复出现危及生命的鼻咽部出血的治疗情况，该假性动脉瘤很可能由扁桃体周围脓肿后的深部颈部感染引起。
一名11岁男孩出现颈部淋巴结病、斜颈和吞咽困难，持续数周。打喷嚏后，患者反复出现大量鼻咽部出血，导致贫血。计算机断层扫描显示左侧咽旁间隙有一个2×2厘米的血肿；血管造影显示颅外ICA在颅底附近有一个囊状动脉瘤（14.1×8.2毫米），无持续出血。最初植入了一个裸Wallstent支架，但仅在裸支架内二次放置Symbiot覆膜支架后才实现完全封堵。
本病例证明了血管内介入治疗儿科患者颅外ICA假性动脉瘤的实用性。
