A potential space between the carotid sheath and the adjacent investing fascia of the neck, allowing the carotid sheath contents to move during swallowing and head rotation. Pathological fluid in this space indicates carotid sheath infection, haematoma, or aneurysm.
Carotid sheath infections (rare) produce a deep neck infection that follows the sheath into the posterior mediastinum — the danger space. Carotid sheath haematoma from anticoagulation or after carotid endarterectomy can compress the airway and neural structures. Carotid body tumour, cervical neurofibroma, and schwannoma all arise within the carotid sheath space. CT with contrast characterises the contents.
Blood accumulation in the carotid sheath space after endarterectomy producing neck swelling and airway compression requiring immediate wound exploration and clot evacuation.
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