The clinical presentation and collateral pathway development of congenital absence of the internal carotid artery
| Autor: | Feng-Xia Yu, Jun Ma, Wang Zheng, Peng Zhang, Liu Xuehuan, Zhenchang Wang, Zhenghan Yang, Han Lv, Wei-Hua Feng |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Male
Computed Tomography Angiography Vascular Malformations Developmental Disabilities Middle meningeal artery 030218 nuclear medicine & medical imaging Ophthalmic Artery 0302 clinical medicine Risk Factors Carotid canal Child Age Factors Middle Aged Prognosis Collateral circulation Adaptation Physiological medicine.anatomical_structure Ischemic Attack Transient Cerebrovascular Circulation Child Preschool Agenesis Female Radiology Internal carotid artery Cardiology and Cardiovascular Medicine Carotid Artery Internal Adult medicine.medical_specialty Subarachnoid hemorrhage Adolescent Collateral Circulation Young Adult 03 medical and health sciences medicine.artery medicine Basilar artery Humans Aged Retrospective Studies business.industry Infant Subarachnoid Hemorrhage medicine.disease Cerebral Angiography Regional Blood Flow Ophthalmic artery Asymptomatic Diseases Surgery business Magnetic Resonance Angiography 030217 neurology & neurosurgery |
| Zdroj: | Journal of Vascular Surgery. 68:1054-1061 |
| ISSN: | 0741-5214 |
| DOI: | 10.1016/j.jvs.2018.01.043 |
| Popis: | Objective The objective of this study was to investigate the clinical presentation, risks, and collateral pathway development of the congenital absence of the internal carotid artery (ICA). Methods Sixty-four patients (10 new patients and 54 patients from the relevant literature) were studied. Data on demographic, clinical, and radiologic features were collected, followed by an analysis of the risks associated with ICA agenesis. Results There were 31 male and 33 female patients whose ages ranged from 5 months to 75 years, with a mean age of 31.1 years. The range of clinical symptoms recorded included transient ischemic attack (17 patients), subarachnoid hemorrhage (12 patients), developmental delay (13 patients), asymptomatic (8 patients), and other symptoms (15 patients). All 64 patients presented with absence of unilateral or bilateral ICAs, as measured by cervical computed tomography angiography or magnetic resonance angiography. The carotid canal was absent in all patients on computed tomography of the base of the skull, and abnormal development of collateral circulation pathways was observed. Five patients presented with basilar artery dilation on angiography. Aneurysms were observed in the angiography results from 16 patients. Ten patients presented with variations in the ophthalmic artery origin (the ophthalmic artery originated from the ipsilateral middle meningeal artery in six patients and from the ipsilateral middle cerebral artery in four patients). Conclusions From analysis of our 10 cases of ICA agenesis and our review of the relevant literature, we conclude that young patients with ICA agenesis may present with developmental delay, subarachnoid hemorrhage, or other developmental abnormalities, whereas older patients most commonly present with transient neurologic events. Complications of carotid agenesis are related to specific anatomic subtypes and the resulting collateral circulation development. |
| Databáze: | OpenAIRE |
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