[Management of the non traumatic dissecting aneurysm of the cervical portion of the internal carotid artery (author's transl)].

The spontaneous dissecting aneurysms of the internal cervical carotid artery are renowned unusual, as about fifty cases only are reported in the literature. About 18 cases of dissecting aneurysms, 5 of which operated on and 13 clinically and radiologically followed, the authors try to draw a management. This one is resolutely conservative because: 1. It is possible to expect the spontaneous evolution according to the radiological form of the dissection which becomes in the great majority of cases toward repermeability. 2. The exceptional cases evolving to the thrombosis can later have an extra-intracranial anastomosis. 3. The cases justifying a direct surgical approach are exceptional and the operatory decision is easily taken according to the radiological aspect. On the whole, this pathology seems less unusual than the literature leads to suppose and the spontaneous evolution is worth to be well known because it conditions the management.