Introduction
Carotid Artery Aneurysms are relatively uncommon. As with all aneurysms, they are a dilatation or swelling of an artery. The carotid artery runs from the chest, through the neck, and up to the brain. If they become too large there is a risk of either rupture or the development of clot inside of them that may affect the blood flow to the brain.
Causes
The precise cause of aneurysms of the carotid artery is not known. There are a number of risk factors that may pre-dispose the development of carotid artery aneurysms.
- Atherosclerosis (hardening of the arteries).
- Smoking.
- Connective tissue disorders (Ehlers Danlos, Marfan Syndrome).
- High blood pressure.
- High cholesterol.
- Trauma.
- Arterial dissection (a split in the artery wall).
Symptoms
Most carotid artery aneurysm have little in the way of symptoms and are detected on imaging performed to investigate other conditions.
They may cause symptoms either due to the increasing size and pressure on surrounding structures or due to clot breaking away and causing damage to the brain.
The symptoms may include:
- A palpable lump in the neck.
- Pain on the side of the neck.
- Hoarse voice.
- Difficulty swallowing.
- Symptoms of stroke.
- Visual loss.
Tests
Carotid artery aneurysms are often detected on ultrasound, CT or MRI scans performed to investigate other conditions. Ultrasound is a good test to confirm the diagnosis. CT Angiography is utilised to plan treatment.
Diagnosis
Diagnosis is confirmed with either ultrasound imaging or CT scanning. Both tests are good methods to diagnose the presence of an aneurysm and also assess the need and options for treatment.
Treatment
Treatment of carotid aneurysm involves:
- Blood pressure treatment.
- Surveillance program if < 2cm in size.
- Treatment if > 2cms in size – endovascular stenting or surgical repair / replacement.>
Which option depends on a number of factors including the size of the carotid aneurysm, the location as well as other medical issues.