Post-traumatic dissection of the cervical ICA with false aneurysm formation : helical CT and angiographic findings in one case

A 20-year-old man presented with mild intracranial bleeding, a Horner's syn drome, and left neck swelling following head injury. Following noncontrast CT of the brain, a contrast-enhanced helical CT was performed through the n eck that showed a hematoma in the poststyloid space (carotid sheath) with i rregular diameter of the ICA. Selective digital subtraction angiography con firmed the presence of left cervical ICA dissection with pseudoaneurysm for mation. The aneurysm was resected and an end-to-end anastomosis was done us ing an inverted saphenous graft. Histology confirmed a diagnosis of traumat ic ICA dissection with pseudoaneurysm formation and there was no evidence o f pre-existing pathology. Helical CT is a simple, widely available, and rel atively non-invasive imaging technique that correlates well with angiograph y. It should be considered in the evaluation of patients with suspected cer vical ICA dissection.