scholarly journals Cervical carotid artery disease in sickle cell anemia: clinical and radiological features

Blood ◽  
2011 ◽  
Vol 118 (23) ◽  
pp. 6192-6199 ◽  
Author(s):  
Paul T. Telfer ◽  
Jane Evanson ◽  
Paul Butler ◽  
Claire Hemmaway ◽  
Chenya Abdulla ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Sickle Cell ◽  
Internal Carotid ◽  
Carotid Artery Disease ◽  
Vascular Lesion ◽  
Nontreated Patient ◽  
Artery Disease ◽  
Neck Vessels ◽  
Carotid Doppler ◽  
Radiologic Features

AbstractCervical internal carotid artery (cICA) occlusion is a recognized cause of acute ischemic stroke (AIS) in sickle cell disease (SCD), but the associated clinical and radiologic features are not well described. We reviewed data on cervical magnetic resonance angiography (cMRA) performed prospectively in 67 patients (55 children) for indications including transcranial Doppler (TCD) abnormalities, AIS, or previous AIS. cICA lesions were seen in 10 (15%) patients, including 4 of 7 patients presenting with AIS, and appear to have been missed on first presentation in 4 of 10 patients with previous AIS. Radiologic features in 7 patients were consistent with dissection. In 2 patients, there was strong clinical and radiologic evidence for thromboembolic AIS, and this was also considered possible in 4 other patients. Three of the 4 AIS patients were anticoagulated acutely, and the nontreated patient had recurrent, probably thromboembolic, AIS. TCD findings were variable, but in 4 patients there were high velocities in the cerebral vessels contralateral to the cICA stenosis. We suggest that all patients with AIS should have cMRA during acute evaluation to identify cICA occlusions that may require anticoagulation. Routine screening of children with SCD should also include evaluation of neck vessels by carotid Doppler followed by cMRA if a cervical vascular lesion is suspected.

Persistent Trigeminal Artery as a Cause of Dizziness

1997 ◽  
Vol 76 (1) ◽  
pp. 43-45 ◽  
Author(s):  
Robert A. Battista ◽  
Jed A. Kwartler ◽  
Daniel M. Martinez
Keyword(s):  
Carotid Artery ◽  
Internal Carotid ◽  
Carotid Artery Disease ◽  
Persistent Trigeminal Artery ◽  
Vertebrobasilar Insufficiency ◽  
Trigeminal Artery ◽  
Aged Woman ◽  
Middle Aged Woman ◽  
Common Problems ◽  
Artery Disease

Complaints of vertigo and dizziness are common problems referred to otolaryngologists for evaluation. Awareness of uncommon causes of dizziness increases the physician's ability to diagnose and treat these patients. We present the case of a middle-aged woman who presented with episodes of vertigo and symptoms suggestive of vertebrobasilar insufficiency. These symptoms were the result of a persistent trigeminal artery (PTA) and occlusive carotid artery disease. A PTA is a carotid-basilar anastomosis that has been reported to be demonstrated on 0.1% to 0.6% of all cerebral angiograms. Persistence of this vessel usually leads to hypoplasia or agenesis of the ipsilateral posterior communicating artery, and leaves the internal carotid artery as the main source of blood supply to the region of the upper brainstem. The appearance and clinical significance of this unusual condition will be discussed.

scholarly journals EARLY MORPHOGENESIS OF VESSELS AND NERVES OF THE NECK

2020 ◽  
Vol 19 (4) ◽  
pp. 56-64
Author(s):  
L. Herasym ◽  
I. Tsumanets
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Carotid Artery Disease ◽  
Body Position ◽  
Cervical Vertebrae ◽  
Cranial Nerves ◽  
Acute Angle ◽  
Total Frequency ◽  
Artery Disease

Carotid artery disease leads to stroke in 30% of cases. The total frequency of carotid artery deformations varies from 10 to 40% depending on the results of angiographic and pathological examinations. Coiling of the internal carotid artery is associated with embryological pathology, and elongation and inflection are the result of fibromuscular dysplasia or changes that are accompanied by atherosclerotic damage to the arteries. Kinking – an artery bend at an acute angle. It can be congenital, when from early childhood there is a violation of cerebral circulation and develops over time from an elongated carotid artery. The formation of inflections contributes to hypertension, the progression of atherosclerosis. Coiling – the formation of a loop of an artery. Despite the smooth running of the loop, the changes in bleeding in it are significant. The nature of bends in coiling can vary depending on body position, blood pressure. The most common is the elongation of the internal carotid or spinal artery, which leads to the formation of smooth curves along the vessel. Elongation of the arteries is usually detected in random studies. The main etiological causes of pathological tortuosity of the internal carotid artery include: congenital deformation of the vascular wall, hypertension, osteochondrosis of the cervical vertebrae, compression of the bracheocephalic arteries, cranial nerves. The review article deals with anatomy and topography of the major vascular-nervous bundle components of the neck on the stages of early ontogenesis from the point of view of surgical correction of departures from their normal development in newborns and children of an early age. However, literary data are controversial and fragmentary concerning anatomical peculiarities of the carotid arteries, internal jugular vein, and vagus. The facts concerning synoptic correlation of the major vascular-nervous bundle components of the neck in fetuses and newborns are not systematized. Carotid artery disease leads to stroke in 30% of cases. The total frequency of carotid artery deformations varies from 10 to 40% depending on the results of angiographic and pathological examinations. 

Surgical Advances for Extracranial Carotid Stenosis

Neurosurgery ◽  
2014 ◽  
Vol 74 (suppl_1) ◽  
pp. S83-S91 ◽  
Author(s):  
Robert E. Harbaugh ◽  
Akshal Patel
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Carotid Endarterectomy ◽  
Internal Carotid ◽  
Carotid Artery Disease ◽  
Carotid Angioplasty ◽  
Artery Disease ◽  
Angioplasty And Stenting ◽  
Carotid Angioplasty And Stenting

Abstract Carotid endarterectomy is a commonly performed operation to prevent stroke in patients who have asymptomatic or symptomatic internal carotid artery atherosclerotic stenosis. Carotid angioplasty and stenting has also been advocated for treatment of these patients. In this article, we address a number of questions for which a review of available data will advance our understanding of the role of carotid endarterectomy in stroke prevention. These include the following: Are carotid endarterectomy and carotid angioplasty and stenting equivalent procedures for the treatment of carotid artery disease? Which patients should be deemed at high risk for carotid endarterectomy? Should carotid endarterectomy be an urgent procedure in symptomatic patients with severe internal carotid artery stenosis? Finally, what is the role of carotid endarterectomy in asymptomatic patients? We also review the senior author's personal experience with >2000 consecutive carotid endarterectomies, with special attention to his present approach to this operation. We believe that carotid endarterectomy, in experienced hands, is a minimally invasive operation that remains the procedure of choice for most patients with carotid artery disease who will benefit from invasive treatment.

scholarly journals CEREBRAL ISCHAEMIA AND STROKE;

2017 ◽  
Vol 24 (12) ◽  
pp. 1823-1827
Author(s):  
Sibghat Ullah Khan ◽  
Naveed Aslam Lashari ◽  
Nadia Irum Lakho ◽  
Ambreen Faisal ◽  
Aamir Hussain
Keyword(s):  
Cerebral Ischemia ◽  
Carotid Artery ◽  
Cerebral Ischaemia ◽  
Carotid Artery Stenosis ◽  
Carotid Artery Disease ◽  
Artery Stenosis ◽  
Colour Doppler ◽  
Doppler Examination ◽  
Artery Disease ◽  
Carotid Doppler

Introduction: Colour Doppler sonography is a well-established widely available,noninvasive, cost effective and a reliable method for assessing cerebrovascular circulation.It has become a valuable completion of the sonographic workup in patients with cerebralischaemia and infarction. Its accuracy is close to angiography. Objectives: To determine thefrequency of significant carotid artery stenosis in patients of cerebral ischaemia/stroke and itscharacterized sonographic appearance of plaque. Study Design: Cross sectional study, basedon nonprobability convenience sample technique. Setting: Department of Radiology, CombinedMilitary Hospital Lahore, using Colour and Power Doppler Ultrasound machine ALOKA SSD-5500. Period: 14 October 2006 to 15 March 2007. Methodology: Total of 50 diagnosed patientsof either gender, aged 30 to 70 years with cerebral ischaemia and stroke were included in thestudy. Carotid Doppler examination was conducted in each patient and findings were recorded.Results: Among 50 patients who underwent carotid Doppler examination for diagnosis ofclinically significant carotid artery stenosis, 35 patients had carotid plaques. 08 patients werediagnosed to have more than 70 % stenosis, 07 patients with more than 50 % and 20 patientsless than 50 % carotid artery stenosis. 15 patients did not show any carotid artery disease.12 patients had bilateral stenosis while 23 had unilateral disease. Mean age of the patientswith and without carotid artery disease was 52 ± 7.87 years. Conclusion: Majority of patientswith Cerebral ischemia/stroke showed carotid artery stenosis on colour Doppler ultrasound.Common age group who developed cerebral ischemia/stroke was above 50years.

Diffusion-weighted MRI in patients with symptomatic internal carotid artery disease

2002 ◽  
Vol 249 (9) ◽  
pp. 1168-1174 ◽  
Author(s):  
Andreas Kastrup ◽  
Jörg B. Schulz ◽  
Irina Mader ◽  
Johannes Dichgans ◽  
Wilhelm Küker
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Carotid Artery Disease ◽  
Diffusion Weighted Mri ◽  
Diffusion Weighted ◽  
Artery Disease

Abstract WP233: Validation of Multi-parametric Ultrasonography Criteria With Catheter Angiography in Internal Carotid Artery Disease: a Multicenter Study

Stroke ◽  
2016 ◽  
Vol 47 (suppl_1) ◽  
Author(s):  
Kristian Barlinn ◽  
Henning Rickmann ◽  
Ali Rabahi ◽  
Hagen H Kitzler ◽  
Andrij Abramyuk ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Carotid Arteries ◽  
Internal Carotid ◽  
Carotid Artery Disease ◽  
False Negative ◽  
Catheter Angiography ◽  
True Negative ◽  
Artery Disease ◽  
Extracranial Ica

Introduction: Novel multi-parametric criteria for duplex ultrasonography (DUS) grading of extracranial internal carotid artery (ICA) steno-occlusive disease have been recently introduced by the German ultrasound expert panel (DEGUM). We sought to determine diagnostic accuracy of the DEGUM criteria against the gold standard catheter angiography. Methods: We prospectively enrolled consecutive patients who routinely underwent diagnostic or therapeutic catheter angiography of the extracranial carotid arteries in four German study sites. Internal carotid artery disease was graded according to the DEGUM multi-parametric criteria for DUS. On angiography, extracranial ICA disease was graded using the NASCET approach. Ultrasonography and endovascular raters were blinded to clinical data and any other imaging modalities. To correspond to clinically relevant NASCET groups, all stenosis measurements were stratified into ranges: normal, mild (1-49%), moderate (50-69%), severe (70-99%) and occlusion. Results: We studied 130 patients who underwent both DUS and catheter angiography for assessment of carotid arteries (mean age, 64±11 years; 67% men; median time between DUS and angiography, 1 day [interquartile range, 2.5]). To date, fifty-two carotid artery pairs were independently rated and available for comparative analysis. Compared with catheter angiography, DUS had the following positive (PPV) and negative predictive values (NPV): PPV 50% and NPV 72% (3 true positive, 3 false positive, 33 true negative, 13 false negative) for detection of moderate, and PPV 57% and NPV 77% (20 true positive, 15 false positive, 13 true negative, 4 false negative) for detection of severe stenosis. Conclusions: Our preliminary data indicate that the novel DEGUM multi-parametric ultrasonography criteria do not eliminate the need for a confirmatory test for identification of clinically relevant grades of extracranial ICA disease.

Surgical Treatment of Carotid Artery Disease

2020 ◽  
Author(s):  
Wesley S. Moore
Keyword(s):  
Ischemic Stroke ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Carotid Endarterectomy ◽  
Internal Carotid ◽  
Carotid Artery Disease ◽  
Carotid Bifurcation ◽  
Eversion Endarterectomy ◽  
Artery Disease ◽  
Carotid Arterial

The rationale for operating on patients with carotid artery disease is to prevent stroke. It has been estimated that in 50 to 80% of patients who experience an ischemic stroke, the underlying cause is a lesion in the distribution of the carotid artery, usually in the vicinity of the carotid bifurcation. Appropriate identification and intervention could significantly reduce the incidence of ischemic stroke. Carotid endarterectomy for both symptomatic and asymptomatic carotid artery stenosis has been extensively evaluated in prospective, randomized trials. Surgical reconstruction of the carotid artery yields the greatest benefits when done by surgeons who can keep complication rates to an absolute minimum. The majority of complications associated with carotid arterial procedures are either technical or judgmental; accordingly, this review emphasizes the procedural aspects of planning and operation considered to be particularly important for deriving the best short- and long-term results from surgical intervention. Specifically, this review covers preoperative evaluation, operative planning, operative technique, postoperative care, follow-up, and alternatives to direct carotid reconstruction. Figures show carotid arterial procedures including recommended patient positioning, the commonly used vertical incision, the alternative transverse incision, mobilization of the sternocleidomastoid muscle to identify the jugular vein, palpation of the internal carotid artery, division of the structures between the internal and external carotid arteries to allow the carotid bifurcation to drop down, division of the posterior belly of the digastric muscle to yield additional exposure of the internal carotid artery, a graphic representation of the measurement of internal carotid artery back-pressure, a central infarct zone surrounded by an ischemic zone, shunt placement, open endarterectomy, eversion endarterectomy, repair of fibromuscular dysplasia, and repair of coiling or kinking of the internal carotid artery. This review contains 17 figures, and 25 references Key words: Carotid artery disease; Carotid endarterectomy; Carotid angioplasty with stenting; Eversion endarterectomy; Open endarterectomy; Carotid plaque; TCAR  

Effects of Anterior Communicating Artery Diameter on Cerebral Hemodynamics in Internal Carotid Artery Disease

Circulation ◽  
1995 ◽  
Vol 92 (10) ◽  
pp. 3122-3131 ◽  
Author(s):  
Francis Cassot ◽  
Valérie Vergeur ◽  
Philippe Bossuet ◽  
Berend Hillen ◽  
Mokhtar Zagzoule ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Carotid Artery Disease ◽  
Cerebral Hemodynamics ◽  
Anterior Communicating Artery ◽  
Artery Disease
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