The most common risk associated with carotid artery aneurysm is:

B. Embolization of mural thrombus.

DISCUSSION: Thrombosis of the aneurysm and internal carotid artery may occur through deposition of laminated clot within the aneurysm and kinking of the outflow tract of the internal carotid artery. However, this is a relatively uncommon clinical presentation for such an aneurysm. The majority of patients with carotid artery aneurysm present with transient ischemic attacks in the ipsilateral cerebral hemisphere secondary to embolization of laminated clot lining the aneurysm wall. If the aneurysm is left uncorrected, most patients ultimately suffer a stroke. Although rare, rupture of a carotid aneurysm is almost always fatal. Rupture usually occurs into the oral cavity or nasopharynx, and death occurs from suffocation. Aneurysms may present with symptoms of dysphagia secondary to pressure on neighboring cranial nerves and the lateral wall of the pharynx. Nevertheless, these presentations do not represent serious risks to the patient.