Vernet's Syndrome Caused by Large Mycotic Aneurysm of the Extracranial Internal Carotid Artery After Acute Otitis Media Case Report

• Published in: Neurologia medico-chirurgica Vol. 50; no. 1; pp. 45 - 48
• Main Authors: AMANO, Mizuki, ISHIKAWA, Eiichi, KUJIRAOKA, Yuji, WATANABE, Shunji, ASHIZAWA, Kei, OGUNI, Eiichi, SAITO, Atsushi, NAKAI, Yasunobu, IKEDA, Hiroaki, ABE, Takashi, UEKUSA, Yoshinori, MATSUMURA, Akira
• Format: Journal Article
• Language: English; Japanese
• Published: Japan The Japan Neurosurgical Society 2010; THE JAPAN NEUROSURGICAL SOCIETY
• Subjects: Accessory Nerve - physiopathology; Accessory Nerve Injuries; Acute Disease - therapy; Aged, 80 and over; aneurysm; Angiography, Digital Subtraction; Carotid Artery, Internal - microbiology; Carotid Artery, Internal - pathology; Carotid Artery, Internal, Dissection - diagnostic imaging; Carotid Artery, Internal, Dissection - microbiology; Carotid Artery, Internal, Dissection - pathology; Consciousness Disorders - etiology; Cranial Nerve Diseases - etiology; Cranial Nerve Diseases - physiopathology; Dizziness - etiology; Ear, Middle - microbiology; Ear, Middle - pathology; Ear, Middle - physiopathology; Embolization, Therapeutic - instrumentation; Embolization, Therapeutic - methods; Fever - microbiology; focal infection; Humans; jugular foramen; lower cranial nerve; Magnetic Resonance Imaging; Male; Mycoses - complications; Mycoses - diagnostic imaging; Mycoses - pathology; Otitis Media - complications; Otitis Media - microbiology; Otitis Media - physiopathology; Otitis Media with Effusion - microbiology; Otitis Media with Effusion - pathology; Otitis Media with Effusion - physiopathology; Prosthesis Implantation - methods; Skull Base - diagnostic imaging; Skull Base - pathology; Syndrome; Tomography, X-Ray Computed; Treatment Outcome; Vagus Nerve - physiopathology; Vagus Nerve Injuries; Vernet's syndrome
• ISSN: 0470-8105; 1349-8029
• DOI: 10.2176/nmc.50.45

An 85-year-old man presented with a rare large aneurysm of the extracranial internal carotid artery (ICA) due to acute otitis media manifesting as Vernet's syndrome 2 weeks after the diagnosis of right acute otitis media. Angiography of the right extracranial ICA demonstrated an irregularly shaped large aneurysm with partial thrombosis. The aneurysm was treated by proximal ICA occlusion using endovascular coils. The ICA mycotic aneurysm was triggered by acute otitis media, and induced Vernet's syndrome as a result of direct compression to the jugular foramen. Extracranial ICA aneurysms due to focal infection should be considered in the differential diagnosis of lower cranial nerve palsy, although the incidence is thought to be very low.