Acute appearance of a carotid pseudoaneurysm during coughing

An adolescent with Behçet's disease presented after an episode of violent coughing with the sudden appearance of a pulsatile mass on his neck (figure 1A). Since childhood, he had been treated with a coumarin derivative (international normalised ratio at admission: 3.2) after cavernous sinus thrombosis and detection of heterozygous mutations in the prothrombin and homocysteine genes. Neurological examination was unremarkable except for mild hoarseness. Imaging revealed a pseudoaneurysm with common carotid artery dissection (figure 1B, C). Two stents were placed. On follow-up, there was no detectable aneurysm. Behçet’s disease is a multisystem inflammatory process of unknown cause. The most common arterial affectation is arterial occlusive disease and aneurysm formation in the medium and greater vessels. Pseudoaneurysm formation is believed to be a consequence of inflammatory obliteration of the vasa vasorum, which leads to a cessation in nutrient flow to the arterial wall, endothelial cell...
Source: Journal of Neurology, Neurosurgery and Psychiatry - Category: Neurosurgery Authors: Tags: Genetics, Neurological injury, Stroke, Trauma CNS / PNS, Ophthalmology, Radiology, Adult intensive care, Vascularitis, Radiology (diagnostics), Ear, nose and throat/otolaryngology, Trauma, Injury Neurological pictures Source Type: research