Department of Neurosurgery, Tokyo Women's Medical University, Tokyo, Japan.
Department of Neurosurgery, Tokyo Women's Medical University Yachiyo Medical Center, Chiba, Japan.
Neuropathology. 2021 Jun;41(3):191-195. doi: 10.1111/neup.12719. Epub 2021 Feb 1.
Extracranial carotid artery aneurysms (ECAAs) are rare, with the etiology mainly classified as degeneration or dissection. Pseudoaneurysms in the region are even rarer and are seen following trauma, iatrogenic injury, or infection. We report a case of extracranial carotid artery pseudoaneurysm (pseudo-ECAA) with a rare clinical course and pathological features. A 58-year-old man presented with swelling and purpura on the left side of his neck after sneezing. Radiological examinations suggested a ruptured left common carotid artery aneurysm. The operative findings were consistent with a pseudoaneurysm. Pathological examination revealed disarrangement and degeneration of smooth muscle fibers in the media, in addition to scattered foci of mucoid accumulation and irregular-shaped cavitation in the medial extracellular matrix, raising the possibility of an intrinsic dysfunction of the vascular wall in the pathological process of pseudoaneurysm formation.
颅外颈动脉动脉瘤（ECAAs）较为罕见，其病因主要分为退行性变或夹层。该区域的假性动脉瘤则更为罕见，可见于创伤、医源性损伤或感染后。我们报告了一例具有罕见临床病程和病理特征的颅外颈动脉假性动脉瘤（假性-ECAAs）病例。一名 58 岁男性在打喷嚏后出现左侧颈部肿胀和瘀斑。影像学检查提示左侧颈总动脉瘤破裂。手术所见符合假性动脉瘤。病理检查显示中膜平滑肌纤维排列紊乱和退行性变，中膜细胞外基质中还存在散在黏液样物质蓄积灶和形态不规则的囊腔，提示在假性动脉瘤形成的病理过程中，血管壁可能存在内在功能障碍。
