Successful surgical management of extracranial high internal carotid aneurysm. A case report
Ohshima, A.; Akimoto, S.; Kozuma, T.; Tanaka, K.; Takagi, A.; Tada, Y.; Idezuki, Y.
Nihon Geka Gakkai Zasshi 86(6): 770-775
1985
ISSN/ISBN: 0301-4894 PMID: 4033628 Document Number: 260489
A 76 year-old woman visited our university hospital with a complaints of dysphagia of 3 months duration and was discovered to have a right internal carotid aneurysm protruding to the right side of the larynx. A day prior to admission, dysarthria and left hemiparesis occurred with sudden onset. These ischemic attacks spontaneously remitted within 48 hours. A carotid arteriogram showed a saccular aneurysm located high in the right internal carotid artery. Four days after admission, aneurysmectomy with end-to-end anastomosis was carried out with the temporary internal shunt under the induced hypertension. There was no sign of ischemic brain damage after the operation. But she suffered from dysphagia due to the NO. 9, 10, and 12 cerebral nerve palsies, which took 5 months to recover completely. Despite several difficulties in the operation for a highly located internal carotid aneurysm, we emphasize in this report the necessity of aneurysmectomy and the establishment of vascular continuity with the aid of internal shunt to prevent the ischemic brain damage.