Spontaneous rupture of the common carotid artery

A spontaneous rupture of the common carotid artery occurred in a 56-year-old, apparently healthy, man. The patient suffered a sudden, painful swelling on the left side of the neck and bulge of the tonsillar fossa simulating a parapharyngeal abscess. Emergency surgical exploration of the neck revealed a 5-mm rent in the common carotid artery 15 mm proximal from the bifurcation. Such abnormalities as aneurysm, thickness, or thinness of the arterial wall were not detected. The rent was closed by sutures during temporal ligation of the carotid artery. The duration of the temporal interruption of the bloodstream was not longer than three minutes. Postoperative examinations did not indicate atherosclerosis or syphilis. There are several possible causes of this rupture.