Head and Neck Imaging

Aneurysm, head and neck

dilated portion of an artery, vein or heart forming a sac filled with fluid or clotted blood, often forming a pulsating tumour. For a general description, see aneurysm. Conventional angiography is the method of choice for planning surgery; magnetic resonance angiography and ultrasonography may also be useful.

Neck aneurysms are often post-traumatic. They occur mainly at the level of the carotid bifurcation (Fig.1), and may show peripheral rim calcifications. Mycotic aneurysms of the carotid artery have been reported to occur secondarily after development of an abscess in the parapharyngeal space.

External carotid aneurysms are rare; post-traumatic superficial temporal artery aneurysms may be seen, and lingual artery aneurysms have also been reported. The appearance of such aneurysms on CT or MRI is variable, depending on the degree of thrombosis, and may mimic a vascular neoplasm.

Venous aneuryms of the external jugular vein have been described.

RH

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Fig.1

Patient presenting with neck swelling and dysphagia. The findings on axial contrast-enhanced CT (a) suggest a saccular aneurysm at the level of the left common carotid artery (arrow), compressing the left pyriform sinus and displacing the larynx; internal jugular vein (arrowhead). Angiography (b) confirms the saccular false aneurysm (arrow).
Aneurysm, head and neck, Fig.1 (a)
Aneurysm, head and neck, Fig.1 (b)