Extracranial Carotid and Vertebral Artery Aneurysm

Abstract

Extracranial aneurysms of the carotid and vertebral arteries are uncommon conditions [1]. The most frequent cause is represented by atherosclerosis, generally in the context of high blood pressure. Besides, fibromuscular dysplasia, inflammatory disorders, and connective tissue disease are alternative causes for the development of aneurysms of the extracranial arteries. A distinction must be made between true aneurysms on the one hand and pseudoaneurysms/false aneurysms or anastomotic aneurysms on the other. In true aneurysms, all components of the arterial wall are present albeit modified by the disease process; the wall of pseudoaneurysms is only partially constituted by the normal arterial parietal components. Blunt trauma may lead to formation of true aneurysms, while penetrating trauma causes more frequently pseudoaneurysms. The V2 segment of the VA is particularly prone to various types of traumatic lesions, both through elongation, angulation, and contusion, direct laceration by penetrating agents or bone fragments. Mycotic aneurysms of the extracranial arteries need particular attention, as the local evolution may be complicated by failure of the vascular reconstruction and, not least, by distal embolization into the cerebral circulation.