Traumatic pseudoaneurysm of the external carotid artery with parotid mass and delayed facial nerve palsy

Abstract Electrothrombosis by copper needle insertion was used to treat three cases of spontaneous carotid-cavernous fistula. These patients had been treated conservatively for 6 months or more, but their symptoms had not improved. Angiography showed that the feeding arteries were branches of both the ipsilateral internal and the ipsilateral external carotid artery. Frontotemporal craniotomy was performed, and copper needles were inserted transdurally into the cavernous sinus. Closure of the fistula was verified by intraoperative angiography in all cases, and the symptoms improved after the operation. However, one patient had postoperative transient 3rd nerve palsy. Another had Gerstmann's syndrome due to narrowing of the internal carotid artery by a needle and worsening of the preoperative 6th nerve palsy. In one case, the operation was uneventful. Based on our experience, we discuss several problems with this technique.

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Traumatic external carotid artery aneurysm causing facial nerve paralysis

International Journal of Oral and Maxillofacial Surgery ◽

10.1016/s0901-5027(05)80713-1 ◽

1991 ◽

Vol 20 (2) ◽

pp. 88-89 ◽

Cited By ~ 5

Author(s):

A.A.Y. Taher

Keyword(s):

Carotid Artery ◽

Facial Nerve ◽

Artery Aneurysm ◽

External Carotid Artery ◽

External Carotid ◽

Facial Nerve Paralysis ◽

Nerve Paralysis ◽

Carotid Artery Aneurysm

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Exposure of the External Carotid Artery Through the Posterior Triangle of the Neck: A Novel Approach to Facilitate Bypass Procedures to the Posterior Cerebral Circulation

Operative Neurosurgery ◽

10.1093/ons/opw024 ◽

2017 ◽

Vol 13 (3) ◽

pp. 374-381 ◽

Cited By ~ 3

Author(s):

Ali Tayebi Meybodi ◽

Michael T. Lawton ◽

Pooneh Mokhtari ◽

Olivia Kola ◽

Ivan H. El-Sayed ◽

...

Keyword(s):

Carotid Artery ◽

Parotid Gland ◽

Facial Nerve ◽

Vertebral Artery ◽

External Carotid Artery ◽

External Carotid ◽

Digastric Muscle ◽

Posterior Triangle ◽

Novel Approach ◽

Far Lateral Approach

Abstract BACKGROUND: The external carotid artery (ECA) is the main high-flow donor for extracranial–intracranial revascularization procedures. However, anatomic restraints limit the availability of ECA in posterior exposures of the craniocervical junction aimed for bypass to distal vertebral artery segments. OBJECTIVE: To examine the feasibility and safety of exposure of the ECA through the posterior triangle of the neck. METHODS: A preliminary feasibility study on the posterior neck exposure of the ECA was performed in 1 cadaveric head (2 sides) followed by a morphometric study on 9 cadaveric heads (18 sides). Through an extension of the muscular stage of the far-lateral approach, the fascial plane between the posterior belly of the digastric muscle and the capsule of the parotid gland was dissected inferior to the C1. Topographic anatomy of the exposed distal segment of the ECA was defined in detail, including bony landmarks and the facial nerve. RESULTS: ECA was found successfully using the proposed technique in all specimens. In 90% of the specimens, ECA was exposed without transgression of the capsule of the parotid gland. The facial nerve was not encountered during the surgical exposures. CONCLUSION: ECA can be safely and effectively exposed through the posterior triangle of the neck using the proposed approach. This method can facilitate extracranial–intracranial bypass procedures to V3/V4 vertebral artery. Advantages of this novel approach are shortening the graft length and surgical timing, less invasiveness, and optimizing surgical trajectories for completion of both donor and recipient bypass anastomosis.

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