Pseudoaneurysm of the vertebral artery presenting as a neck swelling: Report of a case

Abstract

A twelve year old boy presented with a firm swelling of three months duration in the left posterior cervical triangle. The swelling was 8 cm in diameter. C T revealed a widened left vertebral canal, erosion of the transverse processes of C₂ and subluxation between C₁ and C₂ with fracture C₂. A spontaneous severe haemorrhage from the swelling compelled an immediate surgical exploration. The extravertebral mass was excised and a dehiscence in the transverse processes was plugged with sternocleidomastoid muscle flap to stop the bleeding. The patient made an uneventful recovery. Sustained questioning of the patient revealed a history of a fall from a bicycle three months prior to the present episode. On re-evaluation of the CT pictures it was concluded that the lesion was a pseudoaneurysm of left vertebral artery and should have been diagnosed as such on the initial CT.