[Aneurysm of the extracranial internal carotid artery treated by neck resection and end-to-end anastomosis under the administration of brain protective substances].

A case of aneurysm of the extracranial internal carotid artery treated by aneurysmal neck resection and end-to-end anastomosis of the internal carotid artery under the administration of Sendai Cocktail, which is composed of 20% mannitol solution, dexamethasone and vitamin E and has brain protective effects from ischemia. The patient, a 55-year-old man, was admitted to Yonezawa City Hospital on October 11, 1984, with chief complaints of transient consciousness disturbance and left hemiparesis. On admission, no neurological deficit was found but pulsatile fixed mass was found in the right submandibular region. CT scan revealed multiple low density areas in the right cerebral hemisphere and right upper cervical mass, which was enhanced in a part. Right carotid angiography revealed aneurysm of the extracranial internal carotid artery. On October 31, 1984, operation was performed. In the operative procedure, it needed temporary occlusion of the right carotid artery for 143 minutes and 14 minutes, because the aneurysm severely adhered to surrounding tissue and extended to the skull base. Collateral circulation through the circle of Willis was poor in this case but ischemic complication was not found. On November 20, 1984, he discharged without neurological deficit. Postoperative angiography, one year after the operation, showed good flow through the site the primary end-to-end anastomosis.