Extracranial Carotid Artery Aneurysm: Symptoms, Treatment


Extracranial carotid artery aneurysm refers
to a bulge or balloon in the wall of one of your carotid arteries. Carotid
arteries are two main blood vessels on either side of your neck that carry
oxygen to your brain. Extracranial carotid artery aneurysm is an uncommon
condition that occurs in the weak point of the artery wall.

The aneurysm may grow gradually and thicken the artery wall, leading to a rupture of the artery in severe cases. Luckily, the extracranial carotid artery aneurysms seldom rupture. However, the blood clot forming in them may break and block blood flow to your brain.

Older aged people should pay more attention to this disease, because when aneurysms or blood clots in them rupture, more obvious and dangerous life-threatening symptoms may occur.

Cause & Risk Factors

Why an aneurysm forms in the carotid
arteries is still unclear. They often develop in the weak or thick points in
the arteries. Risk factors that may weaken your artery wall include:

  • Older age
  • Smoking
  • Atherosclerosis
  • High blood pressure
  • Connective tissue disorders
  • A family history of aneurysms


When the aneurysm in the carotid artery is not large, extracranial carotid artery aneurysms don’t always trigger symptoms. But if they grow large enough, you can experience signs and symptoms like:

  • Difficulty swallowing
  • Facial swelling
  • A hoarse voice
  • Severe headache
  • A stroke or a transient ischemic attack (TIA) when the blood clots
    break away
  • Vision problems, such as blurred or double vision, chronically
    dilated pupils, as well as pain above and behind the eyes


To diagnose an extracranial carotid artery
aneurysm, your doctor will perform a physical exam and ask about the symptoms
you have. Other imaging tests that can help the doctor confirm the diagnosis

  • Angiography
  • CT scan (computed tomography)
  • Echocardiography (ultrasound testing)
  • MRI (magnetic resonance imaging)


The aims of treating extracranial carotid artery aneurysm are to reduce symptoms and the risk of life-threatening complications. Each patient will be examined, and treatment will be tailored based on the patient’s conditions. If the aneurysm is small and does not trigger any symptoms, no specific treatment is needed other than regular physical exams and imaging tests to check for signs of changes.

In other cases, treatment options that may
be helpful include:

  • Surgical repair

This is the mainstay of treating extracranial
carotid artery aneurysm. First, the doctor will resect the portion of the
carotid artery involved with the aneurysm. Then, a bypass is performed from the
normal artery below the aneurysm to the normal artery above the aneurysm.

  • Endovascular stent grafting

Your surgeon will enter through a puncture
in one of the arteries in your groin, using catheters to guide and deliver a
stent-graft through the blood vessels to the site of the aneurysm. The graft is
then expanded inside the artery and held in place with metallic hooks.

  • Medications

If you have high blood pressure, your physician may prescribe blood pressure medication to lower your overall blood pressure. Additionally, your physician may prescribe a statin (or cholesterol-lowering medication) to maintain the health of your blood vessels. Besides, thrombolysis may be used to eliminate clots that block blood flow.

Keyword: extracranial carotid artery aneurysm.

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