Carotid artery aneurysm

Pathophysiology

  1. Aetiology
    • Atherosclerosis
    • Dissection
    • Trauma
    • Previous carotid surgery 

 

Approach

  • Expose neck
  • Proceed as for neck examination
  1. Inspect
    • Pulsatile swelling noted in line of carotid artery at base of neck
    • Normally unilateral
  2. Palpate
    • Firm
    • Expansile
  3. Percuss
  4. Auscultate
    • Usually a bruit is heard

Completion

  1. Look for neurological associations (ipsilateral horner's syndrome; focal neurological signs)
  2. Examine for cardiovascular associations (BP, peripheral pulses, heart)

Investigations

  • Duplex scan
  • Digital subtraction angiography