Spontaneous internal carotid artery rupture during neck dissection in osteogenesis imperfecta patient.

Abstract

Several connective tissue disorders are associated with vascular wall abnormalities, including spontaneous dissection of the cervical arteries. Osteogenesis imperfecta (OI) is a hereditary disorder, with rare neurovascular complications, which potentially lead to life-threatening events. We presented a case of spontaneous internal carotid artery (ICA) rupture that occurred in a 52-year-old-woman, suffering from OI type I, and who underwent a bilateral modified radical neck dissection (mRND) plus total thyroidectomy for a T4aN1b thyroid cancer. During mRND, an ICA's spontaneous rupture occurred. Histopathologic report suggested a structural defect of the arterial wall without cancer infiltration. The patient did not experience any neurologic complications. Head and neck surgeons have to be aware about early clinical recognition of possible cervical vascular abnormalities, in patients with connective tissue disorders, potentially responsible for dramatic vascular rupture during cervical surgical procedures.