Ameli F M, Provan J L, Keuchler P M
J Cardiovasc Surg (Torino). 1983 Jan-Feb;24(1):69-73.
Aneurysms of the extracranial internal carotid artery are rare and only 4 cases have been treated at the Wellesley Hospital since 1969. These aneurysms usually present as a painless lump in the neck and the 4 cases to be described manifest unusual presentations. One patient with a history of facial sepsis presented in the Emergency Department with what was thought to be a neck abscess. This was incised and drained before the true nature of the swelling was appreciated. Two patients presented with nerve palsies, one with a hypoglossal palsy due to stretching of the hypoglossal nerve over a large aneurysm and the second with recurrent laryngeal nerve palsy as a result of rupture of a false aneurysm from disruption of a saphenous vein patch inserted following carotid endarterectomy 9 months earlier. The fourth patient presented with a carotid bruit and had a stenosis distal to the aneurysm. Although rare, carotid aneurysms require recognition and early treatment if neurological sequelae are to be avoided.
颅外颈内动脉瘤较为罕见，自1969年以来，韦尔斯利医院仅治疗过4例。这些动脉瘤通常表现为颈部无痛性肿块，本文描述的4例表现出不同寻常的症状。一名有面部脓毒症病史的患者在急诊科就诊，最初被认为是颈部脓肿。在明确肿胀的真正性质之前，脓肿已被切开引流。两名患者表现为神经麻痹，一名因舌下神经在巨大动脉瘤上受牵拉而出现舌下神经麻痹，另一名因9个月前颈动脉内膜切除术后植入的大隐静脉补片破裂导致假性动脉瘤破裂，进而出现喉返神经麻痹。第四名患者表现为颈动脉杂音，动脉瘤远端有狭窄。虽然罕见，但为避免神经后遗症，颈动脉动脉瘤需要得到识别并尽早治疗。
