Authors: Tuvell, Nancy; Sorrell, Kathryn

Source: Journal for Vascular Ultrasound, Volume 29, Number 4, December 2005 , pp. 207-211(5)

Publisher: Society for Vascular Ultrasound

Abstract:

Background.—Neurofibromatosis (NF) is a common genetic disorder responsible for the development of neuroectodermal tumors throughout the body. Although vascular involvement with these growths is uncommon, arteriovenous malformations, aneurysms, stenosis, and occlusions have been reported. We report a case of a patient with NF who presented with a ruptured internal carotid artery aneurysm and then developed a common carotid pseudoaneurysm with subsequent hemorrhage during repair. The use of duplex ultrasound (DU) in the initial diagnosis and follow-up management of this patient will be discussed.

Case Report.—A 31 year-old man with a history of NF presented to the emergency department with pharyngitis and right neck swelling. The initial DU revealed a 2.4-cm distal right internal carotid artery (RICA) aneurysm, which was treated with a covered stent. On the first postoperative day, a new wall irregularity in the right common carotid artery measuring 1.6 cm and a high resistant Doppler signal in the RICA suggesting distal occlusion were demonstrated by DU. A transcranial duplex supported the ICA occlusion by demonstrating cross filling from the left to the right through the anterior communicating artery. Because of increased neck swelling, DU was repeated on the third day. At the site of the previously noted CCA irregularity, a 3.4-cm pseudoaneurysm had developed. During attempted repair in the endovascular suite, the patient developed massive hemorrhage. To control bleeding, intravascular coils were used to occlude the right external carotid artery, RICA, and right common carotid artery. An intraoperative DU confirmed the successful occlusion of the carotid vessels.

Conclusion.—DU provided an accurate initial and follow-up diagnosis of the carotid aneurysms in a patient with vascular complications from NF.

Document Type: Case report

Publication date: 2005-12-01

More about this publication?

• The Journal for Vascular Ultrasound (JVU) is the official journal of the Society for Vascular Ultrasound. It consists of original scientific and educational articles, case studies, book reviews, technical reviews, ultrasound principle reviews, viewpoints, letters to the editor, and CME tests. Regular reading of JVU, published quarterly, will keep you current in your field and provide essential information that can be applied in your practice.
  
  Previously known as the Journal of Vascular Technology - View Volumes 16-26 here
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