Internal carotid artery narrowing in children with retropharyngeal lymphadenitis and abscess

BACKGROUND AND PURPOSE: Our purpose was to describe the association between narrowing of the internal carotid artery (ICA) and retropharyngeal abscess in children. METHODS: Neck CT scans from 13 consecutive children with suppurative retrop haryngeal lymphadenitis and abscess were evaluated retrospectively for asym metric ICA diameters at the level of the abscess. Clinical status at the ti me of illness was established via a chart review. Twenty control CT scans o btained from pediatric patients with normal imaging findings were evaluated prospectively to determine symmetry and size of the ICA, RESULTS: Mean diameter of the normal ICA, contralateral to the retropharyng eal abscess, was 5 mm (range, 3-8 mm), while mean diameter ipsilateral to t he abscess was 3 mm (range, 1-5 mm), The diameters of the normal and abnorm al ICAs were statistically significantly different. All children were neuro logically normal. The right and left ICAs in children with normal CT findin gs in the neck were symmetrical in diameter. CONCLUSION: Despite dramatic narrowing of the ICA ipsilateral to retrophary ngeal lymphadenitis and abscess, no children in this series had neurologic deficits, suggesting that such narrowing is a common, benign, and, most lik ely, incidental imaging finding.