Atypical Common Carotid Artery Diaphragm With an Accompanying Aneurysm

Abstract

Carotid diaphragm was first described in 1967 by Ehrenfeld et al. 1 Ehrenfeld W.K. Stoney R.J. Wylie E.J. Fibromuscular hyperplasia of the internal carotid artery. Arch Surg. 1967; 95: 284-287 Crossref PubMed Scopus (54) Google Scholar It is also described with several other names—fibromuscular hyperplasia, atypical fibromuscular dysplasia, atypical fibromuscular hyperplasia, septa, pseudovalvar fold, diaphragm or webs. 2 Lenck S. Labeyrie M.A. Saint-Maurice J.P. et al. Diaphragms of the carotid and vertebral arteries: an under-diagnosed cause of ischaemic stroke. Eur J Neurol. 2014; 21: 586-593 Crossref PubMed Scopus (48) Google Scholar Carotid diaphragm can cause artery stenosis primarily affecting the internal carotid artery (ICA) beyond the bulb segment. It usually occurs in young or middle-aged individuals. 3 Joux J. Chausson N. Jeannin S. et al. Carotid-bulb atypical fibromuscular dysplasia in young Afro-Caribbean patients with stroke. Stroke. 2014; 45: 3711-3713 Crossref PubMed Scopus (94) Google Scholar The onset of symptoms typically begins with syncopal spell, tinnitus and ischemic stroke. 4 Morgenlander J.C. Goldstein L.B. Recurrent transient ischemic attacks and stroke in association with an internal carotid artery web. Stroke. 1991; 22: 94-98 Crossref PubMed Scopus (70) Google Scholar Although more than 50 cases have been reported in which all lesions showed as stenosis located in the ICA, in this article, we report a unique common carotid artery (CCA) diaphragm with an accompanying aneurysm.