Presentation
Pulsatile right-sided neck swelling for the past year.
Patient Data
The brachiocephalic trunk is seen emanating from the arch of the aorta and continuing superiorly to the neck on the right side. It bifurcates into the right subclavian and the right common carotid arteries at about 4 cm above the right sternoclavicular joint, corresponding to the level of the C7 vertebral body. No fusiform or saccular dilatation. There is no area of stenosis noted in all the vessels.
Impression: high-riding brachiocephalic trunk (normal variant).
The brachiocephalic trunk is seen on the right side of the neck, bifurcating into the right subclavian and right common carotid arteries at about 4 cm from the right sternoclavicular joint. Demonstrates normal color filling. No aneurysmal dilatation was seen.
Case Discussion
The brachiocephalic trunk is meant to bifurcate at a level behind the right sternoclavicular joint. However, in the case of a high-riding brachiocephalic trunk, it bifurcates at a level above the right sternoclavicular joint. The common presentation is that of pulsatile right neck mass.
Therefore, surgeons should be informed about these vascular variants before making any form of intervention in order to avoid some complications, such as excess hemorrhage or a tracheo-brachiocephalic artery fistula.
Unable to process the form. Check for errors and try again.