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J Neuroimaging. 2010 Jul;20(3):287-9. doi: 10.1111/j.1552-6569.2009.00376.x. Epub 2009 Apr 6.

Noninvasive imaging of carotid giant pseudoaneurysm.

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Department of Neurology, La Paz University Hospital, Autónoma de Madrid University, Madrid, Spain.



A 54-year-old man presented an acute stroke in the right middle cerebral artery territory. The carotid duplex ultrasound revealed an aneurismatic mass in the right proximal internal carotid artery (ICA) with a lumen and an organized thrombus inside. The multislice angio-CT (MSACT) showed a giant saccular pseudoaneurysm involving the right ICA. Surgical resection of the aneurysm was performed, with proximal anastomosis between internal and external carotid artery. Pathological study revealed a pseudoaneurysm with a thrombosed wall.


Spontaneus ICA pseudoaneurysms are a rare cause of stroke that must be considered in the differential diagnosis of cervical masses. Duplex ultrasound and carotid MSACT are noninvasive methods that may provide an accurate diagnosis.

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