Background. Pseudoneurysms of the carotid artery are rarely encountered in clinical practice. When encountered they are most likely secondary to acute neck trauma, and involve the internal carotid. External carotid artery involvement is very rare. Methods. We report a case of an external carotid aneurysm following a neck dissection review the literature and discuss the investigation and management of these unusual lesions. Results. Incidence is 0.07%, but mortality can be as high as 30%. Clinical features include swelling and neurological complications. Diagnosis is with a high index of suspicion and imaging with duplex ultrasonography and CT angiography. Management options include observation, anticoagulation, ligation of the carotid artery with or without a bypass procedure, and arterial reconstruction. Conclusion. Early management with appropriate imaging and treatment to prevent significant mortality and morbidity is recommended.
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