{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T15:02:13Z","timestamp":1761058933191},"reference-count":39,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1986,2]]},"abstract":"<jats:p content-type=\"fine-print\">\u2713 Results, complications, and operative techniques of the surgical management of 20 aneurysms of the distal extracranial internal carotid artery (ICA) in 19 patients are reviewed. The proximity of these aneurysms to the styloid process is not considered as a chance occurrence, and the possibility is raised that these lesions are related to trauma from that structure. False aneurysms from spontaneous dissections are believed to occur only in those dissections that begin distally; they are not found in dissections that begin proximally. Treatment was individualized and dependent upon: 1) the size and location of the aneurysm; 2) symptomatology; and 3) hemodynamic considerations based upon intraoperative cerebral blood flow (CBF) measurements determined from the clearance of xenon-133 injected into the ipsilateral ICA. Methods of treatment included: resection of the aneurysm with placement of an interposition saphenous vein graft in seven patients; resection of the aneurysm with end-to-end anastomosis of the ICA in five; ICA ligation in three; clipping of the aneurysm in one; and extracranial-to-intracranial bypass in four. One patient sustained a postoperative cerebral ischemic complication from embolization which resulted in a mild permanent impairment in right hand dexterity. There were no other cerebral ischemic complications in the group, largely attributable, it is thought, to the use of intraoperative CBF measurements and continuous electroencephalograms. Four patients had transient dysphagia from traction damage to the pharyngeal and superior laryngeal nerves, and one patient with preoperative difficulty in swallowing required a gastrostomy. Long-term results have been excellent. Use of the operating microscope facilitated the suturing of the distal anastomosis in cases in which the ICA was reconstructed by an interposition vein graft or end-to-end anastomosis.<\/jats:p>","DOI":"10.3171\/jns.1986.64.2.0169","type":"journal-article","created":{"date-parts":[[2009,5,8]],"date-time":"2009-05-08T16:19:59Z","timestamp":1241799599000},"page":"169-182","source":"Crossref","is-referenced-by-count":101,"title":["Surgical management of aneurysms of the distal extracranial internal carotid artery"],"prefix":"10.3171","volume":"64","author":[{"given":"Thoralf M.","family":"Sundt","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bruce W.","family":"Pearson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David G.","family":"Piepgras","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"O. Wayne","family":"Houser","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bahram","family":"Mokri","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"437","DOI":"10.3171\/jns.1966.25.4.0437","article-title":"Bilateral extracranial aneurysm of the internal carotid artery. Case report.","volume":"25","author":"Alexander","year":"1966"},{"key":"b2","series-title":"Stroke","doi-asserted-by":"publisher","first-page":"723","DOI":"10.1161\/01.STR.12.6.723","article-title":"Thresholds in cerebral ischemia \u2014 the ischemic penumbra.","volume":"12","author":"Astrup","year":"1981"},{"key":"b3","series-title":"Stroke","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1161\/01.STR.8.1.51","article-title":"Cortical evoked potential and extracellular K+ and H+ at critical levels of brain ischemia.","volume":"8","author":"Astrup","year":"1977"},{"key":"b4","series-title":"Ann Surg","doi-asserted-by":"publisher","first-page":"82","DOI":"10.1097\/00000658-196201000-00009","article-title":"Aneurysm of the common carotid artery due to cystic medial necrosis treated by excision and graft.","volume":"155","author":"Barnes","year":"1962"},{"key":"b5","series-title":"Postgrad Med","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1080\/00325481.1962.11692659","article-title":"Extracranial aneurysms of the carotid artery. Report of seven cases.","volume":"32","author":"Beall","year":"1962"},{"key":"b6","series-title":"Acta Neurol Scand","first-page":"1","article-title":"Cerebral hemodynamics in carotid surgery.","author":"Boysen","year":"1973"},{"key":"b7","series-title":"Am J Surg","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1016\/0002-9610(80)90422-5","article-title":"Selective management of extracranial carotid arterial aneurysms.","volume":"140","author":"Busuttil","year":"1980"},{"key":"b8","series-title":"Ann Surg","doi-asserted-by":"publisher","first-page":"222","DOI":"10.1097\/00000658-196402000-00007","article-title":"Arteriosclerotic aneurysm of the extracranial internal carotid artery treated by excision and primary re-anastomosis under controlled hypertension.","volume":"159","author":"Buxton","year":"1964"},{"key":"b9","series-title":"Stroke","doi-asserted-by":"publisher","first-page":"439","DOI":"10.1161\/01.STR.1.6.439","article-title":"Temporary occlusion of the middle cerebral artery in the monkey: clinical and pathological observations.","volume":"1","author":"Crowell","year":"1970"},{"key":"b10","series-title":"Surgery","first-page":"1004","article-title":"Traumatic false aneurysm of the cervical internal carotid artery.","volume":"66","author":"Deysine","year":"1969"},{"key":"b11","series-title":"Arch Surg","first-page":"228","article-title":"False aneurysm after carotid endarterectomy.","volume":"104","author":"Ehrenfeld","year":"1972"},{"key":"b12","series-title":"Can J Sci Neurol","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1017\/S0317167100024690","article-title":"Spontaneous disection of cervico-cerebral arteries.","volume":"5","author":"Fisher","year":"1978"},{"key":"b13","series-title":"Eye Ear Nose Throat Monthly","first-page":"83","article-title":"Aneurysm of internal carotid artery found during tonsillectomy.","volume":"26","author":"Fox","year":"1947"},{"key":"b14","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"207","DOI":"10.1227\/00006123-198009000-00001","article-title":"Cervical carotid dissecting aneurysms.","volume":"7","author":"Friedman","year":"1980"},{"key":"b15","series-title":"Vascular Surgery.","first-page":"1131","article-title":"Aneurysms of the extracranial carotid artery","author":"Goldstone","year":"1977"},{"key":"b16","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"352","DOI":"10.3171\/jns.1964.21.5.0352","article-title":"Excision of arteriosclerotic anurysm of the cervical internal carotid artery.","volume":"21","author":"Halasz","year":"1964"},{"key":"b17","series-title":"Ann Surg","doi-asserted-by":"publisher","first-page":"777","DOI":"10.1097\/00000658-197212000-00020","article-title":"Congenital aneurysm of the extracranial carotid arteries.","volume":"176","author":"Hammon","year":"1972"},{"key":"b18","series-title":"Circ Res","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1161\/01.RES.36.1.18","article-title":"Comparison of 85krypton and 133xenon cerebral blood flow measurements before, during, and following focal, incomplete ischemia in the squirrel monkey.","volume":"36","author":"Hanson","year":"1975"},{"key":"b19","series-title":"Guys Hosp Rep","first-page":"207","article-title":"Two cases of bleeding from the ear from carotid aneurysm.","volume":"103","author":"Harrison","year":"1954"},{"key":"b20","series-title":"J Cardiovasc Surg","first-page":"620","article-title":"Aneurysms following endarterectomy associated with patch graft angioplasty.","volume":"15","author":"Hejhal","year":"1974"},{"key":"b21","series-title":"AJNR","first-page":"27","article-title":"Spontaneous cervical cephalic arterial dissection and its residuum: angiographic spectrum.","volume":"5","author":"Houser","year":"1984"},{"key":"b22","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"773","DOI":"10.3171\/jns.1981.54.6.0773","article-title":"Thresholds of focal cerebral ischemia in awake monkeys.","volume":"54","author":"Jones","year":"1981"},{"key":"b23","series-title":"Surgery","first-page":"946","article-title":"Aneurysms of the extracranial carotid artery.","volume":"72","author":"Kaupp","year":"1972"},{"key":"b24","series-title":"Arch Surg","doi-asserted-by":"publisher","first-page":"865","DOI":"10.1001\/archsurg.1973.01350180097028","article-title":"Carotid artery aneurysm associated with nonbacterial suppurative arteritis.","volume":"106","author":"Kim","year":"1973"},{"key":"b25","series-title":"Am J Surg","doi-asserted-by":"publisher","first-page":"196","DOI":"10.1016\/0002-9610(79)90144-2","article-title":"Aneurysms of the extracranial carotid artery. Twenty-one years' experience.","volume":"137","author":"McCollum","year":"1979"},{"key":"b26","series-title":"Anesthesiology","doi-asserted-by":"publisher","first-page":"430","DOI":"10.1097\/00000542-197010000-00013","article-title":"The effects of anesthesia and hypothermia on canine cerebral ATP and lactate during anoxia produced by decapitation.","volume":"33","author":"Michenfelder","year":"1970"},{"key":"b27","series-title":"Mayo Clin Proc","first-page":"310","article-title":"Extracranial internal carotid artery aneurysms.","volume":"57","author":"Mokri","year":"1982"},{"key":"b28","series-title":"Am J Surg","doi-asserted-by":"publisher","first-page":"771","DOI":"10.1016\/0002-9610(63)90490-2","article-title":"Cervical carotid aneurysms: treatment by excision and restoration of arterial continuity.","volume":"105","author":"Raphael","year":"1963"},{"key":"b29","series-title":"Arch Surg","doi-asserted-by":"publisher","first-page":"339","DOI":"10.1001\/archsurg.1976.01360220035006","article-title":"Aneurysms of extracranial carotid arteries.","volume":"111","author":"Rhodes","year":"1976"},{"key":"b30","series-title":"Arch Surg","doi-asserted-by":"publisher","first-page":"786","DOI":"10.1001\/archsurg.1972.04180110103027","article-title":"Carotid artery aneurysm. Review of the literature and report of a case with rupture into the oropharynx.","volume":"105","author":"Rittenhouse","year":"1972"},{"key":"b31","series-title":"Ann Surg","doi-asserted-by":"publisher","first-page":"673","DOI":"10.1097\/00000658-193705000-00005","article-title":"Aneurysm in the cervical portion of the internal carotid artery. An analytical study of the cases recorded in the literature between August 1, 1925 and July 31, 1936. Report of two new cases.","volume":"105","author":"Shipley","year":"1937"},{"key":"b32","series-title":"Circ Res","doi-asserted-by":"publisher","first-page":"703","DOI":"10.1161\/01.RES.30.6.703","article-title":"Focal transient cerebral ischemia in the squirrel monkey. Effect on brain adenosine triphosphate and lactate levels with electrocorticographic and pathologic correlation.","volume":"30","author":"Sundt","year":"1972"},{"key":"b33","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"310","DOI":"10.3171\/jns.1974.41.3.0310","article-title":"Cerebral blood flow measurements and electroencephalograms during carotid endarterectomy.","volume":"41","author":"Sundt","year":"1974"},{"key":"b34","series-title":"Mayo Clin Proc","first-page":"533","article-title":"Correlation of cerebral blood flow and electroencephalographic changes during carotid endarterectomy, with results of surgery and hemodynamics of cerebral ischemia.","volume":"56","author":"Sundt","year":"1981"},{"key":"b35","series-title":"Arch Surg","doi-asserted-by":"publisher","first-page":"80","DOI":"10.1001\/archsurg.1957.01280070084010","article-title":"Surgical management of cervical carotid aneurysms.","volume":"74","author":"Thompson","year":"1957"},{"key":"b36","series-title":"Brain","doi-asserted-by":"publisher","first-page":"681","DOI":"10.1093\/brain\/90.3.681","article-title":"The microvasculature and microcirculation of the cerebral cortex after arterial occlusion.","volume":"90","author":"Waltz","year":"1967"},{"key":"b37","series-title":"Arch Surg","doi-asserted-by":"publisher","first-page":"501","DOI":"10.1001\/archsurg.1969.01340160081019","article-title":"Aneurysms of the extracranial internal carotid artery.","volume":"99","author":"Webb","year":"1969"},{"key":"b38","series-title":"Arch Surg","doi-asserted-by":"publisher","first-page":"689","DOI":"10.1001\/archsurg.1926.01130110090008","article-title":"Extracranial aneurysm of the internal carotid artery. History and analysis of the cases registered up to Aug. 1, 1925.","volume":"13","author":"Winslow","year":"1926"},{"key":"b39","series-title":"Arch Surg","doi-asserted-by":"publisher","first-page":"803","DOI":"10.1001\/archsurg.1964.01310230079016","article-title":"Aneurysm of internal carotid artery treated by excision and anastomosis to external carotid artery.","volume":"88","author":"Wychulis","year":"1964"}],"container-title":["Journal of Neurosurgery"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/64\/2\/article-p169.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/64\/2\/article-p169.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/64\/2\/article-p169.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,7,24]],"date-time":"2022-07-24T18:00:06Z","timestamp":1658685606000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/64\/2\/article-p169.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1986,2]]},"references-count":39,"journal-issue":{"issue":"2"},"URL":"https:\/\/doi.org\/10.3171\/jns.1986.64.2.0169","relation":{},"ISSN":["0022-3085"],"issn-type":[{"value":"0022-3085","type":"print"}],"subject":[],"published":{"date-parts":[[1986,2]]}}}