Carotid arteriospasm.

Area of Science:

• Vascular Surgery
• Neurology
• Anesthesiology

Background:

• Arteriospasm, a myogenic reflex, can cause artery constriction.
• It may result from surgical manipulation or perivascular blood.
• This reflex can impede collateral blood flow, lasting minutes to days.

Observation:

• Carotid artery spasm can occur after neurosurgical procedures, endarterectomies, and chiropractic manipulation.
• A case of carotid arteriospasm following branchial cleft cyst excision is presented.
• Vessel constriction can be observed during surgical procedures.

Findings:

• Topical local anesthetics are effective for intraoperative vessel constriction.
• Nonoperative management includes transfusion, hydration, oxygenation, and blood pressure support.
• Prompt recognition and intervention are crucial for preventing ischemic complications.

Implications:

• Understanding arteriospasm mechanisms aids in preventing post-procedural ischemic strokes.
• Effective diagnostic and therapeutic strategies are essential for vascular and neurological patient care.
• This reflex highlights the importance of meticulous surgical technique and perioperative management.