EURORAD ESR

Case 2092

Salmonella mycotic aneurysm of the extracranial internal carotid artery

Author(s)
M. Sidiropoulou , T. Gerukis , M. Ekonomou , V.Kalpakidis , P. Palladas
 
Patient
male, 72 year(s)
 
 
  • Published 28.02.2003
  • DOI 10.1594/EURORAD/CASE.2092
  • Section Cardiovascular
  • Case Type Clinical Cases
  • Difficulty Senior
  • Views 20352
  • Language(s)
  • Figure 1
    US Doppler
     

    Just distal to the origin of the right internal carotid artery, dilation of the vessel corresponding to the aneurysm is demonstrated. There is partial visualisation of the right internal jugular vein (arrow).

     
    Area of Interest: unknown; Imaging Technique: US Doppler;

    Longitudinal view of the aneurysm with diameter of 2cm.

     
    Area of Interest: unknown; Imaging Technique: US Doppler;

    Transverse view of the aneurysm.

     
    Area of Interest: unknown; Imaging Technique: US Doppler;

    Abnormal Doppler velocity waveform within the internal carotid aneurysm. The spectrum is untypical and high velocity ranges are demonstrated due to turbulent flow.

     
    Area of Interest: unknown; Imaging Technique: US Doppler;
     
     
  • Figure 2
    Initial DSA

    Selective right carotid angiogram (lateral projection) demonstrates a large aneurysm arising distal to the origin of the right internal carotid artery, separating ICA from ECA.

     
    Area of Interest: unknown; Imaging Technique: Initial DSA;
     
     
  • Figure 3
    Initial CT
     

    Axial CT (dynamic iv contrast administration) at the level of the mandible (2 weeks after the patient's admission to hospital) demonstrates the rim-enhancing lesion which corresponds to the large abscess (arrowheads)....

     
    Area of Interest: unknown; Imaging Technique: Initial CT;

    Axial CT (dynamic iv contrast administration) at the hyoid level demonstrates the right common carotid artery (arrow) surrounded by the abscess where air can be noted (arrowheads).

     
    Area of Interest: unknown; Imaging Technique: Initial CT;

    Axial CT (dynamic iv contrast administration) at the thyroid cartilage level shows the abscess infiltrating the right sternocleidomastoid muscle. Notice the very small lumen of the compressed right internal jugular...

     
    Area of Interest: unknown; Imaging Technique: Initial CT;
     
     
  • Figure 4
    Follow-up DSA

    Lateral view shows thrombosis of the entire right internal carotid artery from its origin (arrow), 24 days after the patient's admission.

     
    Area of Interest: unknown; Imaging Technique: Follow-up DSA;
     
     
  • Figure 5
    Follow-up CT
     

    Axial CT (dynamic iv contrast administration) at the level of the mandible demonstrates thrombosis of the internal carotid artery (arrow) within the abscess, which now is of reduced size (1 month after the patient's...

     
    Area of Interest: unknown; Imaging Technique: Follow-up CT;

    Axial CT (dynamic iv contrast administration) just below the hyoid level reveals compression of the right internal jugular vein (arrow) due to the abscess and the presence of carotid wall thrombus (1 month after the...

     
    Area of Interest: unknown; Imaging Technique: Follow-up CT;
     
     
Just distal to the origin of the right internal carotid artery, dilation of the vessel corresponding to the aneurysm is demonstrated. There is partial visualisation of the right internal jugular vein (arrow).
 
Longitudinal view of the aneurysm with diameter of 2cm.
 
Transverse view of the aneurysm.
 
Abnormal Doppler velocity waveform within the internal carotid aneurysm. The spectrum is untypical and high velocity ranges are demonstrated due to turbulent flow.
 
Selective right carotid angiogram (lateral projection) demonstrates a large aneurysm arising distal to the origin of the right internal carotid artery, separating ICA from ECA.
 
Axial CT (dynamic iv contrast administration) at the level of the mandible (2 weeks after the patient's admission to hospital) demonstrates the rim-enhancing lesion which corresponds to the large abscess (arrowheads). The oropharynx is compromised. Note the anterior displacement of the almost occluded right internal carotid artery (arrow).
 
Axial CT (dynamic iv contrast administration) at the hyoid level demonstrates the right common carotid artery (arrow) surrounded by the abscess where air can be noted (arrowheads).
 
Axial CT (dynamic iv contrast administration) at the thyroid cartilage level shows the abscess infiltrating the right sternocleidomastoid muscle. Notice the very small lumen of the compressed right internal jugular vein (arrow).
 
Lateral view shows thrombosis of the entire right internal carotid artery from its origin (arrow), 24 days after the patient's admission.
 
Axial CT (dynamic iv contrast administration) at the level of the mandible demonstrates thrombosis of the internal carotid artery (arrow) within the abscess, which now is of reduced size (1 month after the patient's admission).
 
Axial CT (dynamic iv contrast administration) just below the hyoid level reveals compression of the right internal jugular vein (arrow) due to the abscess and the presence of carotid wall thrombus (1 month after the patient's admission).
 
 
 
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