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January 19, 1979

Cervical Internal Carotid Aneurysm From Syphilis—An Alternative to Resection

Author Affiliations

Lutheran Medical Center Cleveland

JAMA. 1979;241(3):238-239. doi:10.1001/jama.1979.03290290012006

To the Editor.—  Syphilis is now rarely reported as a cause of internal carotid artery aneurysm1; more characteristically, it involves the ascending aorta. The diagnosis requires serological testing because pathological findings may be difficult to demonstrate.We describe a patient with syphilitic aneurysm of the internal carotid artery that was treated by progressive clamping.

Report of a Case.—  A 24-year-old hypertensive woman was seen in August 1970 with a five-day history of left periorbital pain and a 48-hour bout of numbness, tingling, and weakness of the right hand, which subsided. Results of serological tests for syphilis and fluorescent treponemal antibody were positive. A radionuclide study was suggestive of aneurysm of the left internal carotid artery; this diagnosis was confirmed by angiography (Fig 1). The intracranial circulation was normal and did not demonstrate crossover.The patient was treated for tertiary syphilis and was readmitted in September 1974 with headache but