May be indistinguishable from carotid blowout (in postradiotherapy setting)
Definitions
CAPA: Focal carotid artery outpouching
Partial or complete disruption of vessel wall
Contained by adventitial sleeve or surrounding hematoma
IMAGING
General Features
CT Findings
MR Findings
Ultrasonographic Findings
Angiographic Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Gross Pathologic & Surgical Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
Angiographic Grading of Blunt Carotid Injuries
Surgical Implications by Grade
Selected References
Vogrig A et al: Stroke in patients with COVID-19: clinical and neuroimaging characteristics. Neurosci Lett. 743:135564, 2021
Wu Y et al: Predisposing factors and radiological features in patients with internal carotid artery dissection or vertebral artery dissection. BMC Neurol. 20(1):445, 2020
Chengazi HU et al: Pathology of the carotid space. Insights Imaging. 10(1):21, 2019
Hakimi R et al: Imaging of carotid dissection. Curr Pain Headache Rep. 23(1):2, 2019
McNally JS et al: Magnetic resonance imaging and clinical factors associated with ischemic stroke in patients suspected of cervical artery dissection. Stroke. 49(10):2337-44, 2018
Mohan S et al: Computed tomography angiography of the neurovascular circulation. Radiol Clin North Am. 54(1):147-62, 2016
Paraskevas KI et al: Fate of distal false aneurysms complicating internal carotid artery dissection: a systematic review. Eur J Vasc Endovasc Surg. 52(3):281-6, 2016
Bodanapally UK et al: Vascular injuries to the neck after penetrating trauma: diagnostic Performance of 40- and 64-MDCT Angiography. AJR Am J Roentgenol. 205(4):866-72, 2015
Scott WW et al: Clinical and radiographic outcomes following traumatic Grade 1 and 2 carotid artery injuries: a 10-year retrospective analysis from a Level I trauma center. The Parkland Carotid and Vertebral Artery Injury Survey. J Neurosurg. 122(5):1196-201, 2015
Foreman PM et al: Extracranial traumatic aneurysms due to blunt cerebrovascular injury. J Neurosurg. 120(6):1437-45, 2014
Paulus EM et al: Blunt cerebrovascular injury screening with 64-channel multidetector computed tomography: more slices finally cut it. J Trauma Acute Care Surg. 76(2):279-83; discussion 284-5, 2014
Roberts DJ et al: Diagnostic accuracy of computed tomographic angiography for blunt cerebrovascular injury detection in trauma patients: a systematic review and meta-analysis. Ann Surg. 257(4):621-32, 2013
Chokshi FH et al: 64-MDCT angiography of blunt vascular injuries of the neck. AJR Am J Roentgenol. 196(3):W309-15, 2011
Reis F et al: Involvement of the oral cavity in a carotid pseudoaneurysm of an adolescent treated by an endovascular procedure. Acta Otolaryngol. 130(1):190-2, 2010
Chern JJ et al: Endovascular stenting of traumatic extracranial carotid artery dissections in the pediatric population: a case report. Cases J. 2:171, 2009
Ellens DJ et al: Radiotherapy-induced common carotid pseudoaneurysm presenting with initially occult upper airway hemorrhage and successfully treated by endovascular stent graft. Am J Otolaryngol. 31(3):195-8, 2009
Provenzale JM et al: Comparison of test performance characteristics of MRI, MR angiography, and CT angiography in the diagnosis of carotid and vertebral artery dissection: a review of the medical literature. AJR Am J Roentgenol. 193(4):1167-74, 2009
Vertinsky AT et al: Comparison of multidetector CT angiography and MR imaging of cervical artery dissection. AJNR Am J Neuroradiol. 29(9):1753-60, 2008
Goode S et al: Intraplaque haemorrhage mimicking carotid pseudoaneurysm on magnetic resonance angiography. Br J Radiol. 80(959):e271-4, 2007
Elijovich L et al: The emerging role of multidetector row CT angiography in the diagnosis of cervical arterial dissection: preliminary study. Neuroradiology. 48(9):606-12, 2006
DeFatta RJ et al: Extracranial internal carotid artery pseudoaneurysm. Int J Pediatr Otorhinolaryngol. 69(8):1135-9, 2005
Posacioglu H et al: Large pseudoaneurysm of the carotid artery in Behçet's disease. Tex Heart Inst J. 32(1):95-8, 2005
Hagiwara A et al: The "botryoid sign": a characteristic feature of rhabdomyosarcomas in the head and neck. Neuroradiology. 43(4):331-5, 2001
Weissman JL et al: Thrombosed aneurysm of the cervical carotid artery: avoiding a retrospective diagnosis. Radiology. 190(3):869-71, 1994
Haynes DS et al: Internal carotid artery aneurysms presenting as neck masses. Otolaryngol Head Neck Surg. 107(6 Pt 1):787-91, 1992
Smith RB 3rd et al: Post-operative false aneurysms of the carotid artery. Am Surg. 36(6):335-41, 1970
Buscaglia LC et al: False aneurysm after carotid endareterectomy. JAMA. 209(10):1529, 1969
Deysine M et al: Traumatic false aneurysm of the cervical internal carotid artery. Surgery. 66(6):1004-7, 1969
STONE PW et al: Pseudoaneurysm of the right common carotid artery. N Y State J Med. 60:1239-41, 1960
Related Anatomy
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Related Differential Diagnoses
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Pathology
Clinical Issues
TERMINOLOGY
Abbreviations
Carotid artery pseudoaneurysm (CAPA)
Synonyms
Carotid artery false aneurysm
Biffl grade III blunt carotid injury
May be indistinguishable from carotid blowout (in postradiotherapy setting)
Definitions
CAPA: Focal carotid artery outpouching
Partial or complete disruption of vessel wall
Contained by adventitial sleeve or surrounding hematoma
IMAGING
General Features
CT Findings
MR Findings
Ultrasonographic Findings
Angiographic Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Gross Pathologic & Surgical Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
Angiographic Grading of Blunt Carotid Injuries
Surgical Implications by Grade
Selected References
Vogrig A et al: Stroke in patients with COVID-19: clinical and neuroimaging characteristics. Neurosci Lett. 743:135564, 2021
Wu Y et al: Predisposing factors and radiological features in patients with internal carotid artery dissection or vertebral artery dissection. BMC Neurol. 20(1):445, 2020
Chengazi HU et al: Pathology of the carotid space. Insights Imaging. 10(1):21, 2019
Hakimi R et al: Imaging of carotid dissection. Curr Pain Headache Rep. 23(1):2, 2019
McNally JS et al: Magnetic resonance imaging and clinical factors associated with ischemic stroke in patients suspected of cervical artery dissection. Stroke. 49(10):2337-44, 2018
Mohan S et al: Computed tomography angiography of the neurovascular circulation. Radiol Clin North Am. 54(1):147-62, 2016
Paraskevas KI et al: Fate of distal false aneurysms complicating internal carotid artery dissection: a systematic review. Eur J Vasc Endovasc Surg. 52(3):281-6, 2016
Bodanapally UK et al: Vascular injuries to the neck after penetrating trauma: diagnostic Performance of 40- and 64-MDCT Angiography. AJR Am J Roentgenol. 205(4):866-72, 2015
Scott WW et al: Clinical and radiographic outcomes following traumatic Grade 1 and 2 carotid artery injuries: a 10-year retrospective analysis from a Level I trauma center. The Parkland Carotid and Vertebral Artery Injury Survey. J Neurosurg. 122(5):1196-201, 2015
Foreman PM et al: Extracranial traumatic aneurysms due to blunt cerebrovascular injury. J Neurosurg. 120(6):1437-45, 2014
Paulus EM et al: Blunt cerebrovascular injury screening with 64-channel multidetector computed tomography: more slices finally cut it. J Trauma Acute Care Surg. 76(2):279-83; discussion 284-5, 2014
Roberts DJ et al: Diagnostic accuracy of computed tomographic angiography for blunt cerebrovascular injury detection in trauma patients: a systematic review and meta-analysis. Ann Surg. 257(4):621-32, 2013
Chokshi FH et al: 64-MDCT angiography of blunt vascular injuries of the neck. AJR Am J Roentgenol. 196(3):W309-15, 2011
Reis F et al: Involvement of the oral cavity in a carotid pseudoaneurysm of an adolescent treated by an endovascular procedure. Acta Otolaryngol. 130(1):190-2, 2010
Chern JJ et al: Endovascular stenting of traumatic extracranial carotid artery dissections in the pediatric population: a case report. Cases J. 2:171, 2009
Ellens DJ et al: Radiotherapy-induced common carotid pseudoaneurysm presenting with initially occult upper airway hemorrhage and successfully treated by endovascular stent graft. Am J Otolaryngol. 31(3):195-8, 2009
Provenzale JM et al: Comparison of test performance characteristics of MRI, MR angiography, and CT angiography in the diagnosis of carotid and vertebral artery dissection: a review of the medical literature. AJR Am J Roentgenol. 193(4):1167-74, 2009
Vertinsky AT et al: Comparison of multidetector CT angiography and MR imaging of cervical artery dissection. AJNR Am J Neuroradiol. 29(9):1753-60, 2008
Goode S et al: Intraplaque haemorrhage mimicking carotid pseudoaneurysm on magnetic resonance angiography. Br J Radiol. 80(959):e271-4, 2007
Elijovich L et al: The emerging role of multidetector row CT angiography in the diagnosis of cervical arterial dissection: preliminary study. Neuroradiology. 48(9):606-12, 2006
DeFatta RJ et al: Extracranial internal carotid artery pseudoaneurysm. Int J Pediatr Otorhinolaryngol. 69(8):1135-9, 2005
Posacioglu H et al: Large pseudoaneurysm of the carotid artery in Behçet's disease. Tex Heart Inst J. 32(1):95-8, 2005
Hagiwara A et al: The "botryoid sign": a characteristic feature of rhabdomyosarcomas in the head and neck. Neuroradiology. 43(4):331-5, 2001
Weissman JL et al: Thrombosed aneurysm of the cervical carotid artery: avoiding a retrospective diagnosis. Radiology. 190(3):869-71, 1994
Haynes DS et al: Internal carotid artery aneurysms presenting as neck masses. Otolaryngol Head Neck Surg. 107(6 Pt 1):787-91, 1992
Smith RB 3rd et al: Post-operative false aneurysms of the carotid artery. Am Surg. 36(6):335-41, 1970
Buscaglia LC et al: False aneurysm after carotid endareterectomy. JAMA. 209(10):1529, 1969
Deysine M et al: Traumatic false aneurysm of the cervical internal carotid artery. Surgery. 66(6):1004-7, 1969
STONE PW et al: Pseudoaneurysm of the right common carotid artery. N Y State J Med. 60:1239-41, 1960
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