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Carotid artery aneurysm. Review of the literature and report of a case with rupture into the oropharynx.

A rapidly expanding carotid aneurysm initially produced partial upper respiratory obstruction and then suddenly ruptured into the oropharynx. Emergency replacement of the aneurysm with use of an internal shunt was successful. The English literature contains reports on 42 patients who have undergone resection of a primary carotid artery aneurysm with restoration of arterial continuity. Arteriosclerosis was the most common cause, and reconstruction consisted of either primary anastomosis (26 patients) or insertion of a graft (16 patients). A neurologic deficit developed in six of the 21 patients who were operated on without benefit of cerebral protection, compared to four of the 21 who had some form of cerebral protection from ischemia.