Management of pseudoaneurysm and cervical hematoma following carotid sheath placement in a patient with middle cerebral artery thrombosis: a case report

Abstract

Background: Middle cerebral artery occlusions are present in up to one third of patients with acute ischemic strokes who are undergoing endovascular mechanical thrombectomy, which, especially with intravenous thrombolysis, effectively treats proximal middle cerebral artery stroke when performed promptly. However, carotid sheath placement carries risks such as pseudoaneurysm and hematoma. Case presentation: This report describes a 73-year-old male of Iranian ethnicity with right middle cerebral artery occlusion who developed a pseudoaneurysm and cervical hematoma after carotid sheath placement during mechanical thrombectomy. Despite these complications, the patient underwent successful surgical repair and recovered fully. Conclusion: This case emphasizes the importance of timely middle cerebral artery thrombectomy and highlights the potential complications of carotid sheath placement. It underscores the need for timely management to minimize risks and achieve optimal outcomes.