Death secondary to unusual vascular complications of head and neck surgery occurred in two cases. An arteriovenous fistula involving the carotid artery and the stump of the internal jugular vein after radical neck dissection resulted in severe intracranial hypertension and death. Such a fistula may be suspected when there are findings of a pulsatile mass, bruit, or venous congestion of the face or eye. Treatment consists of resection of the fistula when possible and arterial reanastamosis.
Thrombosis of the internal carotid artery occurred following radical neck dissection without demonstrable arterial trauma. Hopefully, an increased awareness by surgeons of the possibility of these vascular complications after neck surgery will result in correct diagnosis and treatment of these problems.