scholarly journals Unilateral absence of internal carotid artery: A rare case report

2022 ◽  
pp. 532-534
Author(s):  
Uddalok Das ◽  
Sahajada Selim ◽  
Ramudar Singh ◽  
Narayan Pandit
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Signs And Symptoms ◽  
Petrous Bone ◽  
Contralateral Side ◽  
Brain Parenchyma ◽  
Limb Weakness ◽  
Rare Case Report ◽  
Recurrent Strokes

Unilateral absence of internal carotid artery (ICA) is a rare congenital anomaly. We present the case of a 35-year-old man with episodes of recurrent strokes in the past and now presenting with right-sided upper limb weakness. Radiological diagnostic workup revealed a thin left ICA in the neck with non-visualization beyond petrous bone in the intracranial course. The ipsilateral brain parenchyma is supplied by vessels from the contralateral side of the Circle of Willis. As the patient had no evidence of a cerebrovascular accident on radiological evaluation and no neurological signs and symptoms, he was discharged with anticoagulant medications with the advice of follow-up. This is the first report to describe a case of ICA agenesis with a pattern of collateral circulation that doesn’t fit any of the six types described by Lie.

scholarly journals Internal carotid artery velocities in patients with unilateral non-arteritic anterior ischemic optic neuropathy

2017 ◽  
Vol 15 (3) ◽  
Author(s):  
Karen Bulan Reyes
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Optic Neuropathy ◽  
Internal Carotid ◽  
Peak Systolic Velocity ◽  
Contralateral Side ◽  
Anterior Ischemic Optic Neuropathy ◽  
Ischemic Optic Neuropathy ◽  
Significant Difference ◽  
Control Study

Objective: This study aims to evaluate and compare the proximal, medial, and distal segments of internal carotid artery (ICA) peak systolic velocities (PSV) in patients with nonarteritic anterior ischemic optic neuropathy (NA-AION) in one eye against the contralateral side with normal eye findings using doppler ultrasound. Methods:  This is a single-center,  prospective, case control study of five patients with unilateral NA-AION.  The peak systolic velocity (PSV) of the proximal, medial, and distal segments of the ICAs on both sides, one side with NA-AION while the contralateral side had normal eye findings, were compared and analyzed. Results: Four females and one male with a mean age of 59 years (SD = 17 years) were included. PSV of the ICA was measured in three segments: Proximal (PICA), Medial (MICA), and Distal (DICA). Mean PSV of eyes with NA-AION was 143cm/sec (SD= 177cm/sec), 159 cm/sec (SD=189 cm/sec), 98 cm/sec (SD=34cm/sec) for PICA, MICA and DICA respectively. Mean PSV of contralateral side without NA-AION was 95cm/sec (SD= 72cm/sec), 101 cm/sec (SD=53cm/sec), 140cm/sec (SD=60 cm/sec) for PICA, MICA and DICA respectively. There was no statistically significant difference between the two groups along the three segments (T-test PICAp=0.369, MICAp=0.402, DICAp=0.112). Conclusion: Mean PSV was higher in eyes with NA-AION at the proximal and medial segments of the ICA, while it was lower at the distal segments compared to the contralateral non-NA-AION side. 

Abstract WP150: BeamSAT MRI Help to Identify Patients at Risk for Intolerance to Temporary Internal Carotid Artery Occlusion During CEA and CAS

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Jun Tanaka ◽  
Kohkichi Hosoda ◽  
Yusuke Yamamoto ◽  
Taichiro Imahori ◽  
Atsushi Fujita ◽  
...  
Keyword(s):  
At Risk ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Preoperative Assessment ◽  
Contralateral Side ◽  
Artery Occlusion ◽  
Carotid Artery Occlusion ◽  
Collateral Flow ◽  
Patients At Risk

Introduction: Pencil Beam type presaturation (BeamSAT) pulse on a major cervical vessel enables selective suppression of blood flow signal of the applied vessel in MR angiography (MRA). By subtracting the BeamSAT pulse-added MRA of an internal carotid artery (ICA) from conventional MRA, only the contralateral ICA image (SubBeamSAT image) can be obtained (Figure A, B). In this way, an ICA-selective MRA with more physiologial flow pattern can be obtained, because it requires no powerful injection of contrast medium. Purpose: The aim of this study was to investigate whether preoperative assessment of the flow of Acom/A1 by SubBeamSAT image and posterior communicating artery (Pcom) by conventional MRA could identify patients at risk for intolerance to intraoperative temporary ICA occlusion. Method: 29 patients who underwent carotid endarterectomy (CEA) (n = 17) or carotid artery stenting (CAS) (n = 12) were enrolled in the current study. All patients underwent the SubBeamSAT images and conventional MRA pre- and post-operatively. Response to ICA temporally occlusion was recorded during the revascularization procedure. Results: Among twenty-nine patients, 4 patients who demonstrate neither the Acom/A1 flow on SubBeamSAT image (Figure. B) nor Pcom flow on MRA showed intolerance. In contrast, the remaining 25 patients who demonstrated Acom/A1 (Figure. A) and/or Pcom flow showed tolerance. Intolerance to ICA occlusion was excellently predicted by visualization of collateral flow via Acom and Pcom (specificity: 100%, sensitivity: 100%, p=0.00004). Conclusions: SubBeamSAT image is useful for evaluating the flow of Acom from A1 portion of the healthy side to A2 portion of the contralateral side, which is often difficult to evaluate with conventional MRA. With the SubBeamSAT image, it is feasible to evaluate the Acom/A1 flow accurately. In conclusion, SubBeamSAT image enables excellent prediction for the intolerance to temporary ICA occlusion.

scholarly journals Aneurysms of the petrous internal carotid artery: anatomy, origins, and treatment

2004 ◽  
Vol 17 (5) ◽  
pp. 1-9 ◽  
Author(s):  
James K. Liu ◽  
Oren N. Gottfried ◽  
Amin Amini ◽  
William T. Couldwell
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Wide Spectrum ◽  
Treatment Options ◽  
Signs And Symptoms ◽  
Current Treatment ◽  
Asymptomatic Patients ◽  
Cranial Nerve Palsies ◽  
Close Observation

Aneurysms arising in the petrous segment of the internal carotid artery (ICA) are rare. Although the causes of petrous ICA aneurysms remain unclear, traumatic, infectious, and congenital origins have been implicated in their development. These lesions can be detected incidentally on routine neuroimaging. Patients can also present with a wide spectrum of signs and symptoms, including cranial nerve palsies, Horner syndrome, pulsatile tinnitus, epistaxis, and otorrhagia. The treatment of petrous ICA aneurysms remains challenging. Treatment options include close observation, endovascular therapies, and surgical trapping with or without revascularization. Management dilemmas exist, particularly for incidental lesions found in asymptomatic patients. The authors review the literature and discuss the anatomy of the petrous ICA as well as the pathophysiological features of aneurysms arising in this region, and they propose a management paradigm with current treatment options.

scholarly journals Recurrent Strokes due to Transient Vasospasms of the Extracranial Internal Carotid Artery

2013 ◽  
Vol 5 (2) ◽  
pp. 143-148 ◽  
Author(s):  
Sigrid Wöpking ◽  
Andreas Kastrup ◽  
Markus Lentschig ◽  
Freimuth Brunner
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Extracranial Internal Carotid Artery ◽  
Recurrent Strokes

scholarly journals Introduction: Surgery of the Central Skull Base

2008 ◽  
Vol 25 (6) ◽  
pp. E1 ◽  
Author(s):  
Vinko V. Dolenc
Keyword(s):  
Surgical Treatment ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Endovascular Treatment ◽  
Internal Carotid ◽  
Petrous Bone ◽  
The Other ◽  
Vascular Lesions ◽  
Anatomical Studies ◽  
Carotid Cavernous Fistulas

With his anatomical studies of the parasellar space, the so-called cavernous sinus (CS), Taptas opened Pandora's box more than 60 years ago. Parkinson continued the anatomical studies, and operated on vascular lesions in the CS with the help of extracorporeal circulation. The need for endovascular treatment of intracavernous internal carotid artery (ICA) aneurysms, as well as carotid–cavernous fistulas (CCFs), was obvious. Serbinenko started with the endovascular treatment of CCFs and ICA aneurysms using a balloon. At nearly the same time, Hakuba undertook surgical treatment of tumorous lesions in the region. Glascock studied the ICA in relation to the petrous bone, and with his studies of the ICA and this artery's relationship to the other structures, it became clear that further understanding of the pathological entities in the parasellar space hinged on additional microanatomical studies.

scholarly journals Balloon-Assisted Coils Embolization for Ophthalmic Segment Aneurysms of the Internal Carotid Artery

2021 ◽  
Vol 12 ◽  
Author(s):  
Liang Chaohui ◽  
Zhang Guang Yu ◽  
Hou Kai
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Balloon Catheter ◽  
Side Wall ◽  
Type A ◽  
Clinical Effects ◽  
Limb Weakness ◽  
Type D ◽  
Ophthalmic Segment Aneurysms

Objective: To explore the role of balloon-assisted coils technique for ophthalmic segment aneurysms (OSAS).Methods: Clinical data of 30 patients with OSAS were reviewed between December 2017 and December 2018. OSAS were defined as arising from the internal carotid artery (ICA), reaching from the distal dural ring to the origin of the posterior communicating artery. OSAS were classified into four types based on the angiographic findings. The balloon-assisted coils technique was used for the embolization of aneurysms. The duration of balloon inflation cycles, as well as difficulty and complications during the embolization procedure, were recorded. The immediate angiographic results were evaluated according to the Raymond scale. Clinical results were evaluated based on the MRS score. Follow-ups were performed at 18 months post-embolization by DSA or MRA at our institution.Results: Thirty-two aneurysms in 30 patients were detected by digital subtraction angiography (DSA), which included 30 unruptured and two ruptured cases. The patients with ruptured aneurysms were grade II status according to the Hunt-Hess scale. Three cases were type A, nine cases were type B, 17 cases were type C, and three cases were type D. According to aneurysm size, there were 19 cases of small, 11 cases of medium, two cases of large aneurysm. Thirty-two aneurysms were successfully embolized in 30 patients by balloon-assisted coils technique. The ophthalmic artery could be protected by an engorged balloon in the procedure, especially for type A aneurysms. Considering that type D aneurysm arises from the side-wall of the artery and near to tortuous ICA siphon, the balloon catheter was inflated to stabilize the microcatheter allowing for overinflation when necessary. The average duration of balloon dilatation was 4 min, and the average time was 2.5 times. Raymond class was one in 28 aneurysms and two in four aneurysms according to the immediate post-embolization angiographic results. All the patients achieved good clinical effects, except for one patient who presented with brain ischemia resulting in dizziness and contralateral limb weakness for 10 h due to prolonged temporary clamping of the responsible ICA. The follow-up angiography results were satisfactory at 18 months post-embolization.Conclusion: OSAS endovascular treatment with balloon-assisted coils has different advantages in a different classification. The technique is safe, effective, and relatively inexpensive, especially for small and medium OSAS.

An unusual presentation of dysarthria in a young patient, a stroke mimic

2021 ◽  
Vol 20 (2) ◽  
pp. 140-143
Author(s):  
D Simpson ◽  
◽  
O David ◽  
F Nasr ◽  
◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Nerve Palsy ◽  
Internal Carotid ◽  
Signs And Symptoms ◽  
Sudden Onset ◽  
Carotid Artery Dissection ◽  
Artery Dissection ◽  
Internal Carotid Artery Dissection ◽  
Stroke Mimic

Internal carotid artery dissection commonly affects younger patients. We present a case of a previously fit and well 43-year-old gentleman who presented with a sudden onset of slurring of speech, with right-sided tongue deviation and fasciculation on examination. Signs and symptoms began following participation in a home workout class. Magnetic resonance angiography revealed right-sided extracrainal internal carotid artery dissection leading to right-sided unilateral twelfth cranial nerve palsy.

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