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Clinical Problem Solving: Radiology
May 01, 2008

Radiology Quiz Case 2: Diagnosis

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Copyright 2008 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2008

Arch Otolaryngol Head Neck Surg. 2008;134(5):557-558. doi:10.1001/archotol.134.5.557

Pseudoaneurysmis a term that is used synonymously with false aneurysm, pulsatile hematoma, and communicating hematoma.1It is defined by the loss of integrity of 1 or more layers of the arterial wall, resulting in an aneurysmal sac that communicates with the lumen of the ruptured vessel and is encapsulated by adventitia and periarterial fibrous tissue. It differs from a true aneurysm, which has an intact but dilated vascular wall. The center cavity of a pseudoaneurysm creates a potential space for blood flow and development of thrombi and emboli, which accounts for the heterogeneous appearance on MRIs. Arterial pressures can stretch and enlarge this aneurysmal sac, eventually causing rupture, compression of the parent-artery lumen, or damage to adjacent structures.2As in the present case, these lesions can also spontaneously thrombose and regress on their own.

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