scholarly journals Low Bifurcation of The Left Common Carotid Artery Associated With Klippel–Feil Syndrome And Severe Stenosis of The Bilateral Proximal Middle Cerebral Artery

2021 ◽  
Author(s):  
Yan Li ◽  
Minli Lv ◽  
Jianquan Zhong
Keyword(s):  
Carotid Artery ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Common Carotid Artery ◽  
Spinous Process ◽  
Left Common Carotid Artery ◽  
Posterior Arch ◽  
Severe Stenosis ◽  
Proximal Middle Cerebral Artery ◽  
Neck Vessels

Abstract BackgroundThe bifurcate position of the common carotid artery is protean. It is most often locating between the C3 and C5 vertebral levels.Intrathoracic bifurcation of common carotid artery is a rare anatomic finding,and an association with bilateral segmental severe stenosis of middle cerebral artery has not been reported in the past literature .we report a case of low bifurcation of the left common carotid artery associated with Klippel–Feil syndrome and severe stenosis of the bilateral proximal middle cerebral artery.Case PresentationA 47-years old woman presented with dizziness and sleep disturbance,whose computed tomography angiography image incidentally revealed an intrathoracic bifurcation of the left common carotid artery associated with bilateral segmental severe narrowing of middle cerebral artery（MCA）.The left transverse process and spinous process of C3-4 fused and posterior arch of atlas did not fuse on Volume rendered（VR） imaging. ConclusionWe should not only pay attention to the variation of the neck vessels, but also to the serious secondary changes of intracranial vessels caused by neck vessels variation. Low carotid bifurcation may cause chronic progressive stenosis /occlusion of the proximal MCA or severe ischemic stroke events .

CHANGES IN BLOOD FLOW OF COMMON CAROTID ARTERY AND MIDDLE CEREBRAL ARTERY DURING EXERCISE

1999 ◽  
Vol 31 (Supplement) ◽  
pp. S194
Author(s):  
N. Murase ◽  
T. Katsumura ◽  
T. Osada ◽  
T. Hamaoka ◽  
Y. Yamamoto ◽  
...  
Keyword(s):  
Blood Flow ◽  
Carotid Artery ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Common Carotid Artery

Abstract WP237: Novel Probe Attached to the Cervix Can Evaluate Right-to-left Shunt More Precisely Than Transcranial Doppler

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Hidetaka Mitsumura ◽  
Ayumi Arai ◽  
Teppei Komatsu ◽  
Kenichi Sakuta ◽  
Kenichiro Sakai ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Middle Cerebral Artery ◽  
Temporal Bone ◽  
Cerebral Artery ◽  
Transcranial Doppler ◽  
Common Carotid Artery ◽  
Valsalva Maneuver ◽  
Center Frequency ◽  
Bone Window ◽  
The Right

Introduction: While the examination for the evaluation of right-to-left shunt (RLS) using contrast transcranial Doppler (TCD) is useful, insufficient temporal bone window interrupts the adequate TCD examination for precise diagnosis of RLS. Thus, we developed a novel probe (paste-able soft ultrasound probe; PSUP) attached to the cervix for RLS diagnosis. Hypothesis: Monitoring at carotid artery using PSUP can detect greater number of contrast microembolic signals (cMES) than that of TCD. Methods: Subjects were patients with ischemic stroke or transient ischemic attack who had one and more cMES in middle cerebral artery detected by screening test of TCD on admission. PSUP was a 2.0-MHz center frequency and had an equal property with TCD transducer. The shape was thin, soft, and square modified for adequate attachment to the neck. We monitored blood flow of unilateral middle cerebral artery by TCD and ipsilateral common carotid artery by PSUP simultaneously. After injection of saline agitated with air in the right antecubital vein, we performed single test without Valsalva maneuver (VM) and triple tests with VM. And then, we compared the number of cMES between PSUP and TCD among each patient. Results: We performed 48 simultaneous PSUP and TCD examination (12 studies without VM, and 36 studies with VM) on 12 patients (11 male, median age of 49 years) without any complication. The number of cMES on PSUP was significantly larger than that of TCD in all of 48 examination (345 vs. 206, p<0.001), in 12 studies without VM (72 vs. 37, p=0.017), and in 36 studies with VM (273 vs. 169, p<0.001). Conclusions: In order to evaluate the RLS, PSUP examination at common carotid artery is a powerful approach in comparison with TCD. For patients without sufficient temporal bone window, PSUP should play an important role of RLS diagnosis.

Combined endovascular and surgical treatment of symptomatic tandem occlusion of common carotid artery and middle cerebral artery – case report

2019 ◽  
Vol 98 (6) ◽  
pp. 252-255
Keyword(s):  
Case Report ◽  
Cerebral Ischemia ◽  
Carotid Artery ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Common Carotid Artery ◽  
Neurologic Deficit ◽  
Cerebrovascular Event ◽  
Tandem Occlusion ◽  
Acute Cerebral Ischemia

Introduction: Cerebrovascular events are among the most common causes of invalidity or death. The aim of treatment in acute cerebral ischemia is to restore the blood flow before irreversible necrosis of brain tissue and persistent neurologic deficit occur. Pharmacological, endovascular and surgical methods are employed in the treatment of these patients. Case report: The authors present a case report of a 56-year-old woman with acute cerebral ischemia caused by tandem occlusion of the left com- mon carotid artery and the M1 segment of middle cerebral artery. In the initial phase the patient was treated by intravenous thrombolysis with minimal success. Common carotid artery was occluded and mechanical extraction of embolus was successfully performed through direct carotid bifurcation puncture. Almost complete regression of neurologic deficit occurred after the endovascular recanalization. Occluded common carotid stump and bifurcation was considered as a source of embolization and therefore, to prevent further cerebrovascular event, a subclavian-carotid bypass was performed on the 15th day after the stroke. Conclusion: In the reported patient with symptomatic tandem occlusion of common carotid artery and the M1 part of middle cerebral artery, recanalization of cerebral artery was attained by the combination of pharmacological and endovascular method. Consequent subclavian-to-carotid bypass was performed in tertiary prevention of further cerebrovascular event.

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