PMC4329680_01
Doppler and CT images of the neck. (A) Doppler image showing aliasing and low-resistance arterial flow within the pseudoaneurysm (arrow) (B) Axial contrast-enhanced CT of the neck showing a hematoma (asterisk) with contrast pooling anterior to the right IJV (long arrow) and the right CCA (small arrow) (C) Coronal CT image of the neck showing contrast pooling (arrow) in the right lower neck
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F1
Doppler evaluation of the swelling showed a large hematoma anterior to the neck vessels with a pseudoaneurysm formation [Figure 1A]. The pseudoaneurysm was in close relation to the right IJV and right CCA, but no definitive communication with either vessel could be demonstrated on the CT angiogram [Figure 1B and C].
Pseudoaneurysm and arteriovenous fistula treated with coiling. (A) Right ECA angiogram, lateral projection (late arterial phase) showing a pseudoaneurysm (long arrow) arising from a branch of the right superior thyroid artery. Early filling of a venous channel is also seen (short arrow), confirming the presence of a fistula (B) Superselective angiogram of the right superior thyroid artery demonstrating the pseudoaneurysm and the arteriovenous fistula (C) Post-coiling angiogram of the right superior thyroid artery showing complete occlusion of the pseudoaneurysm and the arteriovenous fistula
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F2
Common and selective right external carotid artery angiograms showed a small pseudoaneurysm arising from the sternocleidomastoid branch of the right superior thyroid artery, with associated arteriovenous fistula [Figure 2A and B] draining into a venous collateral. Post-embolization check angiogram showed complete occlusion of the pseudoaneurysm and the arteriovenous fistula [Figure 2C].