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<p>Brachiocephalic trunk (BCT) pseudoaneurysms are very uncommon, representing around 1% of peripheral aneurysms. Atherosclerosis is the typical etiology; nevertheless, mycotic pseudoaneurysms resulting from tuberculosis (TB) are very rare and pose significant diagnostic and therapeutic difficulties. We describe a 22-year-old male with a history of pulmonary TB who had hemoptysis, cough, fever, and discomfort in the right upper limb. Computed tomography angiography (CTA) identified a substantial, partly thrombosed saccular pseudoaneurysm of the BCT. An emergency surgical repair was executed with a Y-shaped Dacron graft to link the ascending aorta with the right subclavian and right common carotid arteries. Histopathology revealed fibrocollagenous tissue accompanied by inflammation, although it lacked conclusive microbiological evidence of TB. The patient recovered without complications and is asymptomatic throughout follow-up. This example underscores the significance of CTA in diagnosis and surgical strategizing, and underlines that prompt surgical intervention is vital for survival in uncommon, life-threatening vascular complications of TB.</p>

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Unveiling the ace in the neck: Mycotic pseudoaneurysm of the brachiocephalic trunk with suspected tubercular etiology

  • 期刊论文

  • 发表日期：

    2025年12月8日

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  • Resham Singh,
  • Gulshan Sharma,
  • Ashish Babarao Lakhote,
  • Pamposh Pandita,
  • Kavita Vani

摘要

Brachiocephalic trunk (BCT) pseudoaneurysms are very uncommon, representing around 1% of peripheral aneurysms. Atherosclerosis is the typical etiology; nevertheless, mycotic pseudoaneurysms resulting from tuberculosis (TB) are very rare and pose significant diagnostic and therapeutic difficulties. We describe a 22-year-old male with a history of pulmonary TB who had hemoptysis, cough, fever, and discomfort in the right upper limb. Computed tomography angiography (CTA) identified a substantial, partly thrombosed saccular pseudoaneurysm of the BCT. An emergency surgical repair was executed with a Y-shaped Dacron graft to link the ascending aorta with the right subclavian and right common carotid arteries. Histopathology revealed fibrocollagenous tissue accompanied by inflammation, although it lacked conclusive microbiological evidence of TB. The patient recovered without complications and is asymptomatic throughout follow-up. This example underscores the significance of CTA in diagnosis and surgical strategizing, and underlines that prompt surgical intervention is vital for survival in uncommon, life-threatening vascular complications of TB.