Successful treatment of ruptured extracranial carotid artery aneurysm and fistula associated with neurofibromatosis type1: Report of two cases

Neurofibromatosis type 1 is an inherited disease. Vascular malformation represents minor complication but the rupture is fatal. We report two cases of ruptured vascular malformation in extracranial carotid artery who survived after successful treatment. Case 1 was a 35-year-old man who presented with airway obstruction due to a mass in the pharynx. The mass was diagnosed as ruptured aneurysm of the right internal carotid artery (ICA). An emergent treatment of superficial temporal artery to middle cerebral artery (STA-MCA) bypass surgery followed by endovascular occlusion of the right ICA was conducted. Case 2 was a 55-year-old man who presented with dyspnea associated with right-side neck swelling. Angiography showed two major high-flow arteriovenous fistulas, mainly fed from the ICA and maxillary artery. The patient also underwent embolization. Early diagnoses and appropriate managements of these rare cases could save lives after the serious condition.