Anomalies of the cerebral arteries in military servants - participants of ATO-OOS, who suffered ischemic strokes

In this study, the circulus arteriosus cerebri of the ground squirrel (<i>Spermophilus citellus</i>) was investigated. Five ground squirrels were used as subjects. Coloured latex was injected from the left ventriculi of the hearts of all the squirrels. When the vertebral arteries of two of the animals were ligatured, it was found that there was no internal carotid artery. After careful dissection, the circulus arteriosus cerebri (the circle of Willis) was investigated. The right and left vertebral arteries gave rise to the caudal cerebellar artery before forming the basilar artery. The basilar artery formed the caudal communicans artery that was the caudal part of the circulus arteriosus cerebri on the pontocrural groove (sulcus pontocruralis). The caudal, medial, rostral cerebellar, the common root formed by the caudal cerebral and choroid arteries, the rostral choroid, the rostral and medial cerebral arteries arose from the vertebral, basilar and caudal communicans arteries and dispersed to the cerebrum and cerebellum from caudal to cranial. The termination and the branches of the rostral cerebral artery in ground squirrels varied. It was observed that the internal carotid artery does not supply the circulus arteriosus cerebri in ground squirrels.

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Abstract WMP40: Cervical Internal Carotid Artery Tortuosity as a Marker of Non-Atherosclerotic Aging: Results From the Northern Manhattan Study (NOMAS)

Stroke ◽

10.1161/str.51.suppl_1.wmp40 ◽

2020 ◽

Vol 51 (Suppl_1) ◽

Author(s):

Farid Khasiyev ◽

Tatjana Rundek ◽

Chensy Marquez ◽

Clinton B. Wright ◽

Ralph Sacco ◽

...

Keyword(s):

Carotid Artery ◽

Internal Carotid Artery ◽

Internal Carotid ◽

Genetic Disorders ◽

Matrix Remodeling ◽

Plaque Area ◽

Blood Pressures ◽

The Right ◽

Cervical Internal Carotid Artery

Background: Cervical internal carotid artery (ICA) tortuosity has been associated with vascular risk and stroke as well as genetic disorders related to abnormal extracellular matrix remodeling. It is plausible that dystrophic or aberrant arterial remodeling may therefore relate to cervical ICA tortuosity. We hypothesized that cervical ICA tortuosity relates to carotid dilatation, but not to traditional ultrasound (US) markers of atherosclerosis. Methods: Subjects of the NOMAS with available time-of-flight MRA were included in our study. Cervical ICA tortuosity was defined as a bend in the distal cervical ICA of > 90° as seen on MRA. We excluded subjects with < 5 cm of the cervical ICA visualized. Distensibility was calculated as the percentage excursion of the right CCA diastolic diameter during systole, which was assessed by high-resolution B-mode US of the right common carotid artery (CCA). We used multivariable logistic regression analyses to estimate odds ratios for the association of cervical ICA tortuosity and Doppler measures of carotid wall aging. Results: We visualized cervical ICA tortuosity in 468 NOMAS participants (mean age 64±8 years, 70% women, 70% Hispanic). It was present in 23% of subjects. In unadjusted models, cervical ICA tortuosity was more common in women (OR 2.34, 95% CI 1.34-4.11), Hispanics (OR 1.85, 95%CI 1.06-3.25) and those with higher diastolic blood pressures (OR per mm Hg 1.04, 95%CI 1.01-1.06), and less common among smokers (OR 0.23, 95%CI 0.07-0.78). In models adjusted for demographic and vascular risks, right CCA tortuosity was associated with ipsilateral larger CCA DD (OR 1.42, 95%CI 1.02-1.96) and borderline associated with lower distensibility (OR 0.94, 95%CI 0.87-1.01, P=0.06) but not with ipsilateral ICA IMT (OR 0.26, 95%CI 0.14-4.77), number of plaques (OR 1.08, 95%CI 0.76-1.53), maximum plaque thickness (OR 0.96, 95%CI 0.73-1.27), or plaque area (1.00, 95%CI 0.97-1.05). Conclusions: Cervical ICA tortuosity associates with ipsilateral cervical ICA dilatation and lower distensibility, but not with traditional US markers of atherosclerosis. The association with diastolic blood pressure suggests a role of steady, rather than pulsatile, hemodynamics in aberrant cervical ICA remodeling.

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Competitive flow diversion of multiple P1 aneurysms: proposed classification

BMJ Case Reports ◽

10.1136/bcr-2019-015581 ◽

2020 ◽

Vol 13 (6) ◽

pp. e015581

Author(s):

Mark Alexander MacLean ◽

Thien J Huynh ◽

Matthias Helge Schmidt ◽

Vitor M Pereira ◽

Adrienne Weeks

Keyword(s):

Subarachnoid Hemorrhage ◽

Carotid Artery ◽

Internal Carotid Artery ◽

Cerebral Artery ◽

Internal Carotid ◽

Posterior Cerebral Artery ◽

Flow Diversion ◽

Endovascular Coiling ◽

Ruptured Aneurysms ◽

The Right

We report the case of a patient with subarachnoid hemorrhage and three aneurysms arising from the posterior communicating artery (Pcomm)-P1 complex, treated with endovascular coiling and competitive flow diversion. The largest and likely ruptured Pcomm aneurysm was treated with traditional coiling. Two smaller potentially ruptured aneurysms arose from the distal right posterior cerebral artery (PCA) P1 segment. After a failed attempt to treat with conventional flow diversion across the PCA-P1 segment, the P1 aneurysms were successfully treated with competitive flow diversion distal to the PCA-P1 segment from Pcomm to the P2 segment. Over 12 months, competitive flow diversion redirected flow to the right PCA territory via the internal carotid artery-Pcomm-P2, reducing the size of the PCA-P1 segment and obliterating the P1 aneurysms. Competitive flow diversion treatment should be considered for aneurysms occurring at the circle of Willis when traditional methods are not feasible. Herein, we introduce a novel classification for competitive flow diversion treatment.

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Republished: Competitive flow diversion of multiple P1 aneurysms: proposed classification

Journal of NeuroInterventional Surgery ◽

10.1136/neurintsurg-2019-015581.rep ◽

2020 ◽

Vol 12 (9) ◽

pp. e7-e7

Author(s):

Mark Alexander MacLean ◽

Thien J Huynh ◽

Matthias Helge Schmidt ◽

Vitor M Pereira ◽

Adrienne Weeks

Keyword(s):

Subarachnoid Hemorrhage ◽

Carotid Artery ◽

Internal Carotid Artery ◽

Cerebral Artery ◽

Internal Carotid ◽

Posterior Cerebral Artery ◽

Flow Diversion ◽

Endovascular Coiling ◽

Ruptured Aneurysms ◽

The Right

We report the case of a patient with subarachnoid hemorrhage and three aneurysms arising from the posterior communicating artery (Pcomm)-P1 complex, treated with endovascular coiling and competitive flow diversion. The largest and likely ruptured Pcomm aneurysm was treated with traditional coiling. Two smaller potentially ruptured aneurysms arose from the distal right posterior cerebral artery (PCA) P1 segment. After a failed attempt to treat with conventional flow diversion across the PCA-P1 segment, the P1 aneurysms were successfully treated with competitive flow diversion distal to the PCA-P1 segment from Pcomm to the P2 segment. Over 12 months, competitive flow diversion redirected flow to the right PCA territory via the internal carotid artery-Pcomm-P2, reducing the size of the PCA-P1 segment and obliterating the P1 aneurysms. Competitive flow diversion treatment should be considered for aneurysms occurring at the circle of Willis when traditional methods are not feasible. Herein, we introduce a novel classification for competitive flow diversion treatment.

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Domestic cat’s internal carotid artery in ontogenesis

Veterinární Medicína ◽

10.17221/116/2020-vetmed ◽

2021 ◽

Author(s):

H Ziemak ◽

H Frackowiak ◽

M Zdun

Keyword(s):

Carotid Artery ◽

Internal Carotid Artery ◽

Internal Carotid ◽

Cerebral Arteries ◽

Domestic Cat ◽

Domestic Cats ◽

Precise Description ◽

Adult Cats ◽

The Brain

The aim of the study was to trace the presence of the internal carotid artery in the system of cerebral arteries of the domestic cat and to determine the role of this artery in supplying blood to the brain in ontogenesis. The available publications provide ambiguous or even contradictory information. The authors of some studies claim that there is no extracranial segment in the domestic cat’s internal carotid artery. Other authors reported the internal carotid artery in the arterial pattern of the encephalon base. The study was conducted on sixty-one domestic cats: fifteen foetuses, sixteen juvenile cats, and thirty adult cats were analysed. The internal carotid artery – a vessel with a relatively large lumen – was fully preserved in all the foetuses and most of the juvenile animals. This artery was not complete with regard to the adults and some juvenile individuals, because it had lost the extracranial segment as a result of the obliteration process. A precise description of this area is not only of biological, but also of clinical, significance. The knowledge of the anatomical structure of cerebral vessels is particularly important to correctly interpret images obtained during diagnostic tests and to conduct surgical procedures correctly.

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Role of Extradural Clinoidectomy and Optic Unroofing in Resection of an Anterior Clinoidal Meningioma with Encasement of the Internal Carotid Artery and Its Branches

Journal of Neurological Surgery Part B Skull Base ◽

10.1055/s-0041-1729996 ◽

2021 ◽

Author(s):

Sima Sayyahmelli ◽

Zhaoliang Sun ◽

Emel Avci ◽

Mustafa K. Başkaya

Keyword(s):

Carotid Artery ◽

Internal Carotid Artery ◽

Skull Base ◽

Vision Loss ◽

Internal Carotid ◽

Extent Of Resection ◽

World Health ◽

Who Grade ◽

The Right ◽

Supraclinoid Internal Carotid Artery

AbstractAnterior clinoidal meningiomas (ACMs) remain a major neurosurgical challenge. The skull base techniques, including extradural clinoidectomy and optic unroofing performed at the early stage of surgery, provide advantages for improving the extent of resection, and thereby enhancing overall outcome, and particularly visual function. Additionally, when the anterior clinoidal meningiomas encase neurovascular structures, particularly the supraclinoid internal carotid artery and its branches, this further increases morbidity and decreases the extent of resection. Although it might be possible to remove the tumor from the artery wall despite complete encasement or narrowing, the decision of whether the tumor can be safely separated from the arterial wall ultimately must be made intraoperatively.The patient is a 75-year-old woman with right-sided progressive vision loss. In the neurological examination, she only had light perception in the right eye without any visual acuity or peripheral loss in the left eye. MRI showed a homogeneously enhancing right-sided anterior clinoidal mass with encasing and narrowing of the supraclinoid internal carotid artery (ICA). Computed tomography (CT) angiography showed a mild narrowing of the right supraclinoid ICA with associated a 360-degree encasement. The decision was made to proceed using a pterional approach with extradural anterior clinoidectomy and optic unroofing. The surgery and postoperative course were uneventful. MRI confirmed gross total resection (Figs. 1 and 2). The histopathology was a meningothelial meningioma, World Health Organization (WHO) grade I. The patient continues to do well without any recurrence and has shown improved vision at 15-month follow-up.This video demonstrates important steps of the microsurgical skull base techniques for resection of these challenging tumors.The link to the video can be found at https://youtu.be/vt3o1c2o8Z0

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Cervical artery dissection—an easily neglected cause of stroke: a case report

BMC Neurology ◽

10.1186/s12883-020-02006-6 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Ya -Hui Lian ◽

Xin Chen ◽

De- Rui Kong ◽

Wei Chen ◽

Ming-Chao Shi ◽

...

Keyword(s):

Young People ◽

Carotid Artery ◽

Internal Carotid Artery ◽

Internal Carotid ◽

Vascular Occlusion ◽

Artery Dissection ◽

High Signal ◽

Cervical Artery Dissection ◽

Cervical Artery ◽

The Right

Abstract Background In recent years, the incidence of stroke has gradually increased in young people. There are many reasons causing stroke, including atherosclerosis, artery embolization, and cervical artery dissection and so on. However, cervical artery dissection is a major cause of stroke in young people. We present a case of ischemic stroke caused by dissection, whose distal vascular occlusion due to detachment of the thrombosis in the right internal carotid artery. Case presentation A 33-year-old male patient was admitted to the hospital because of stroke. Imaging examination showed that there was no visualization of the right middle cerebral artery and there were a large number of mural thrombus in the C1 segment of the right internal carotid artery. After emergency surgery, the patient had vascular recanalization and the symptoms were significantly improved. Magnetic resonance imaging showed a high signal in the C1 segment of the right internal carotid artery, the abnormal signal disappeared after antiplatelet therapy. Conclusions When a patient has symptoms of stroke, we need to explore the root cause of stroke. Especially in young people, cervical artery dissection is an important reason that can’t be ignored. Through review and analysis of this case, we hope to improve the understanding of radiologists and clinicians about the cervical artery dissection, reduce the rate of misdiagnosis, and improve patients’ prognosis.

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Intrasellar Intercarotid Communicating Artery Associated with Agenesis of the Right Internal Carotid Artery: Case Report

Neurosurgery ◽

10.1227/00006123-198812000-00019 ◽

1988 ◽

Vol 23 (6) ◽

pp. 770-773 ◽

Cited By ~ 6

Author(s):

Masahiko Udzura ◽

Hiroo Kobayashi ◽

Yoshio Taguchi ◽

Hiroaki Sekino

Keyword(s):

Magnetic Resonance Imaging ◽

Carotid Artery ◽

Internal Carotid Artery ◽

Internal Carotid ◽

Spatial Relationship ◽

Resonance Imaging ◽

Anomalous Artery ◽

Magnetic Resonance Imaging Mri ◽

The Right ◽

Relationship Of

Abstract A 54-year-old man with a right hemiparesis was found to have an intrasellar intercarotid communicating artery associated with agenesis of the right internal carotid artery. Magnetic resonance imaging (MRI) studies demonstrated the spatial relationship of the anomalous artery to the surrounding structures, thus suggesting an embryonic enlargement of the capsular artery as a source of this anomalous artery.

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Absence of the right internal carotid artery found during autopsy of a severe burn case

Legal Medicine ◽

10.1016/j.legalmed.2007.01.009 ◽

2007 ◽

Vol 9 (5) ◽

pp. 270-273

Author(s):

Masakazu Hanagama ◽

Hiromasa Inoue ◽

Kotaro Shinone ◽

Masakatsu Tanaka ◽

Masayuki Nata

Keyword(s):

Carotid Artery ◽

Internal Carotid Artery ◽

Internal Carotid ◽

Severe Burn ◽

The Right

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Endovascular plug for internal carotid artery occlusion in the management of a cavernous pseudoaneurysm with bifrontal subdural empyema: technical note

Journal of Neurosurgery Pediatrics ◽

10.3171/2017.3.peds16370 ◽

2017 ◽

Vol 20 (3) ◽

pp. 239-246

Author(s):

Sunil Manjila ◽

Gagandeep Singh ◽

Obinna Ndubuizu ◽

Zoe Jones ◽

Daniel P. Hsu ◽

...

Keyword(s):

Carotid Artery ◽

Internal Carotid Artery ◽

Sphenoid Sinus ◽

Internal Carotid ◽

Balloon Catheter ◽

Arterial Injury ◽

Technical Note ◽

Subdural Empyema ◽

Artery Pseudoaneurysm ◽

The Right

The authors demonstrate the use of an endovascular plug in securing a carotid artery pseudoaneurysm in an emergent setting requiring craniotomy for a concurrent subdural empyema.They describe the case of a 14-year-old boy with sinusitis and bifrontal subdural empyema who underwent transsphenoidal exploration at an outside hospital. An injury to the right cavernous segment of the ICA caused torrential epistaxis. Bleeding was successfully controlled by inflating a Foley balloon catheter within the sphenoid sinus, and the patient was transferred to the authors’ institution. Emergent angiography showed a dissection of the right cavernous carotid artery, with a large pseudoaneurysm projecting into the sphenoid sinus at the site of arterial injury. The right internal carotid artery was obliterated using pushable coils distally and an endovascular plug proximally. The endovascular plug enabled the authors to successfully exclude the pseudoaneurysm from the circulation. The patient subsequently underwent an emergent bifrontal craniotomy for evacuation of a left frontotemporal subdural empyema and exenteration of both frontal sinuses. He made a complete neurological recovery.Endovascular large-vessel sacrifice, obviating the need for numerous coils and antiplatelet therapy, has a role in the setting of selected acute neurosurgical emergencies necessitating craniotomy. The endovascular plug is a useful adjunct in such circumstances as the device can be deployed rapidly, safely, and effectively.

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