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Register a new userExtra Cranial Carotid Artery Aneurysm: A Case Report
أم دم الشريان السباتي خارج القحف: دراسة حالة مرضية
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تعد أم دم الشريان السباتي خارج القحف نادرة جداً، و تقدر ب 0.4 - 4% فقط من أمهات دم الشرايين المحيطة. جرت أول محاولة إصلاح جراحية ناجحة لأم دم الشريان السباتي الباطن خارج القحف من قبل كوبر Cooper عام 1808. تنال أمهات الدم هذه الاهتمام بسبب تنوع أسباب المرض و التحديات الكبيرة سواء في التشخيص أو في العلاج. تختلف تظاهرات أمهات الدم تبعاً لموقعها و حجمها و الآلية المرضية المسببة لها، إِذ تبدأ هذه التظاهرات من كتلة لا عرضية في العنق إلى عجز عصبي مستمر كنتيجة للصمات الميكروية المنطلقة من كيس أم الدم. تحدث معظم أمهات الدم على أرضية تصلب عصيدي، و لكن هناك آليات أخرى كالرض و الإنتان. تشخص أمهات دم الشريان السباتي عادة باستخدام الأمواج فوق الصوتية، و تستخدم فحوص تشخيصية أخرى كالطبقي المحوري الوعائي و الرنين المغناطيسي و التصوير الوعائي للحصول على معلومات أكثر دقة عن حجم أم الدم و علاقتها بالبنى المجاورة. نقدم هنا تقرير حالة عن أم دم شريان سباتي باطن أيمن عند مريضة تبلغ من العمر 46 سنة، راجعت بأعراض عصبية، تم اللجوء لتركيب شبكة مغلفة داخل أم الدم كونها تقع في الجزء البعيد من الشريان السباتي الباطن، دون وجود اختلاطات بعد 10 أشهر من المتابعة بعد العلاج. في الخاتمة، تعد أم دم الشريان السباتي حالة نادرة، و ذات اختلاطات عالية عند اللجوء للعلاج المحافظ.
Extracranial carotid artery aneurysm (ECAA) is extremely rare, accounting for only 0.4-4% of all peripheral artery aneurysms. Sir Astley Cooper is credited with the first successful operation for ECAA in 1808. These aneurysms are of interest because they have diverse etiologies and present diagnostic and therapeutic challenges. The symptoms of ECAAs vary according to their location, size, and etiology. The presentation of such aneurysms may vary from an asymptomatic mass in the neck to the development of a permanent neurological deficit as a consequence of micro emboli arising from within the aneurysmal sac. Although most carotid artery aneurysms are caused by atherosclerosis, other common causes include trauma and infection. Carotid artery aneurysms are usually diagnosed by means of ultrasonographic scanning. Additional diagnostic testing -by computed tomographic angiography, or magnetic resonance imaging- can lead to more accurate information on the aneurysm’s size and its relationship to surrounding structures. We herein report an extra cranial carotid artery aneurysm detected in a 46 years old patient with complaint of neurologic Symptoms. Because aneurysm located in the distal ICA, the treatment involved stent graft deployment. There has been no complications noted during the 10 months follow up after treatment. In conclusion, Extra Cranial Carotid Artery Aneurysm is a rare condition and has high rate of complication with conservative approach.
References used
Marvin DA,Ruth LB. Carotid Artery Disease : Aneurysms . Volume 2 . Section 14. Chapter 98 in Cronenwett JL, Johnston W (eds.): Rutherford’s Vascular Surgery, Seventh Edition. Philadelphia: WB Saunders/Elsevier, 2010, pages 1497-511
Li Z, Chang G, Yao C, Guo L, Liu Y, Wang M, Liu D, Wang S. Endovascular stenting of extracranial carotid artery aneurysm: a systematic review. Eur J Vasc Endovasc Surg. 2011 Oct;42(4):419-26
Wong E, Chue WL. Hybrid (open and endovascular) repair of distal extra-cranial Internal carotid artery aneurysm. European Journal of Vascular and Endovascular Surgery, Volume 40, Issue 4, October 2010: e19-21
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