Carotid artery aneurysm as a rare cause for aspiration pneumonia. A case report

A now 92-year-old patient presented in 1990 with a massive 6 x 4 x 4 cm aneurysm of the left internal carotid artery which completely occluded the left oro- and nasopharynx. The main complaint of dysphagia was not only a consequence of the narrowed pharynx but was also due to a palsy of the glosso-pharyngeal nerve and caused one to two episodes of aspiration pneumonia per year. The patient could not be operated on because the aneurysm extended to the base of the skull. Remarkably the patient never experienced a cerebral ischemic event and during a follow-up of five years the aneurysm did not increase in size and partial thrombosis of the aneurysm was never detected. Thus conservative management seems feasible, when partial thrombosis of the aneurysm can be ruled by CT-examination.