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Clinical Problem Solving: Radiology
January 2005

Radiology Quiz Case 1—Diagnosis

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Copyright 2005 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2005

Arch Otolaryngol Head Neck Surg. 2005;131(1):76-77. doi:10.1001/archotol.131.1.76-a

An EICA pseudoaneurysm is an extremely rare condition in childhood.1,2 Generally, aneurysms of the internal carotid artery (ICA) are observed intracranially; only 5.6% of carotid artery aneurysms are extracranial, and the upper cervical region is an atypical site for pseudoaneurysm formation.2 Atherosclerosis and trauma are the most common etiologic factors for EICA aneurysms, followed by local infections, periarteritis, congenital defects, and fibromuscular dysplasia. Besides developing after penetrating and blunt injuries of the head and neck, traumatic pseudoaneurysms have been reported to form after various surgical procedures, including carotid endarterectomy3 and tonsillectomy.4 Deep neck infections are also a rare cause of aneurysms of the ICA and have been reported in the literature only since the advent of the antibiotic era.5,6 Mycotic pseudoaneurysm of the ICA is an uncommon entity that is seen rarely, and only in immuncompromised children.6,7 Trauma is the leading cause of pseudoaneurysms of the carotid artery in children and young adults.

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