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Internal carotid artery

Z Y Jia, L B Zhao, D H Lee
BACKGROUND AND PURPOSE: Segmental intracranial dolichoectasia of the distal ICA is a feature of PHACE syndrome or a sporadic phenomenon. We evaluated the relationship between intracranial dolichoectasia of the distal ICA and PHACE syndrome and illustrated the characteristic radiologic findings of the lesions. MATERIALS AND METHODS: Intracranial dolichoectasia of the distal ICA was identified in 20 patients at our institution from 2005 to 2016 through a review of diagnostic cerebral angiography results...
March 15, 2018: AJNR. American Journal of Neuroradiology
Narayanam Anantha Sai Kiran, Veldurti Ananta Kiran Kumar, Laxminadh Sivaraju, Valluri Anil Kumar, Chintakunta Rajesh Reddy, Amit Agrawal
BACKGROUND: Aberrant medial retropharyngeal prevertebral course of internal carotid arteries (ICAs) is extremely uncommon. In oropharyngeal surgeries like trans oral odontoidectomy (TOO) this unrecognized aberrant retropharyngeal course of ICAs can result in devastating complications secondary to inadvertent injury of ICAs. Authors describe this aberrant course of ICAs in a patient with craniovertebral junction (CVJ) anomaly with dysmorphic C1 lateral mass on one side and discuss in detail various management issues in this complex case...
March 12, 2018: World Neurosurgery
Yoshitaka Shimizu, Takahito Okazaki, Tomoaki Hamana, Masahiro Irifune
Treatment of pseudoaneurysms in the internal carotid artery (ICA) is associated with a high risk of cerebral infarction; therefore, vessel ligation for hemostasis must be avoided. A 66-year-old man had intraoral hemorrhaging. At the time of the initial examination, computed tomography angiography showed jaw plate displacement near the ICA. A more detailed image was obtained using digital-subtraction angiography. After evaluation of the image, a pseudoaneurysm was diagnosed. Six days later, there were concerns about aspiration and airway obstruction; therefore, tracheostomy was performed...
February 20, 2018: Journal of Oral and Maxillofacial Surgery
D A Gol'bin, V A Cherekaev
The article presents the literature data on the structural variability and age-related features of the midline anatomical structures of the anterior skull base (frontal sinus, ethmoid bone, anterior parasellar region, and medial orbital wall). This is the area of surgical interests of neurosurgeons and rhinosurgeons. The study objective is to analyze the literature data on the individual variability and age-related anatomy of these structures. The work is illustrated with original images from the authors' personal archive...
2018: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
Poonam Sagar, Arif Kavungal Nambillath, Vikas Malhotra, Ajay Raj, Abhay Anand
Extracranial carotid artery aneurysms are rare but important entity. Impending rupture of such aneurysms can lead to catastrophic hemorrhage, airway compromise and may prove fatal. The authors report a case of true aneurysm of cervical internal carotid artery in a four-year-old girl who presented with fever and swelling of neck and oropharynx. High clinical suspicion is required to differentiate aneurysm from peritonsillar and parapharyngeal abscess as incision and drainage can prove fatal. Securing airway beforehand and timely embolization has led to the favorable outcome in the present case...
March 15, 2018: Indian Journal of Pediatrics
Beth M Kline-Fath, Arnold C Merrow, Maria A Calvo-Garcia, Usha D Nagaraj, Howard M Saal
Fetal ventriculomegaly is a common referral for prenatal MRI, with possible etiologies being hydrocephalus and hydranencephaly. The underlying cause of hydranencephaly is unknown, but many have suggested that the characteristic supratentorial injury is related to idiopathic bilateral occlusions of the internal carotid arteries from an acquired or destructive event. Fowler syndrome is a rare genetic disorder that causes fetal akinesia and a proliferative vasculopathy that can result in an apparent hydranencephaly-hydrocephaly complex...
March 14, 2018: Pediatric Radiology
Henry Zhao, Lauren Pesavento, Skye Coote, Edrich Rodrigues, Patrick Salvaris, Karen Smith, Stephen Bernard, Michael Stephenson, Leonid Churilov, Nawaf Yassi, Stephen M Davis, Bruce C V Campbell
BACKGROUND AND PURPOSE: Clinical triage scales for prehospital recognition of large vessel occlusion (LVO) are limited by low specificity when applied by paramedics. We created the 3-step ambulance clinical triage for acute stroke treatment (ACT-FAST) as the first algorithmic LVO identification tool, designed to improve specificity by recognizing only severe clinical syndromes and optimizing paramedic usability and reliability. METHODS: The ACT-FAST algorithm consists of (1) unilateral arm drift to stretcher <10 seconds, (2) severe language deficit (if right arm is weak) or gaze deviation/hemineglect assessed by simple shoulder tap test (if left arm is weak), and (3) eligibility and stroke mimic screen...
March 14, 2018: Stroke; a Journal of Cerebral Circulation
Michael Kerin Morgan, Mathew Guilfoyle, Ramez Kirollos, Gillian Z Heller
BACKGROUND: Avoiding the risk of postoperative hemorrhage after brain arteriovenous malformation (AVM) resection involves aggressive blood pressure control. Remodeling of the feeding arterial system is critical in reducing this risk. OBJECTIVE: To investigate factors predicting time to return to normal on digital subtraction angiography (DSA) after AVM resection. METHODS: For AVM in which the largest feeding artery (FA) on DSA was in the anterior circulation, the preoperative and postoperative diameter of the FA were compared with the diameter of the internal carotid artery (IC) immediately proximal to the posterior communicating artery...
March 12, 2018: Neurosurgery
Anup Singh, Kapil Sikka, Nishchint Jain, Leve Joseph Devarajan
Endovascular treatment is a standard mode of treatment for traumatic cavernous internal carotid artery (ICA) pseudoaneurysms with good results and relatively low rates of complications. We describe a case of an unusual, potentially fatal, delayed postoperative event happening in a case of post-traumatic pseudoaneurysm of ICA, which had been previously managed with endovascular coiling.
March 2018: Neurointervention
Soumik Das, Arun Kumar Gupta, Arvinda Hanumathapura Ramalingiah
We report here a rare complication in the form of kinking of flow diverter in a case of giant wide-necked supraclinoid internal carotid artery (ICA) aneurysm 48 hours after the procedure. This 28-year female presented with giant wide-necked right supraclinoid ICA aneurysm which was managed by flow diversion. On 2nd post-op day, patient developed weakness of left side with altered sensorium - angiography and CT showed kinking of flow diverter at the neck of the aneurysm with poor distal flow. Eventually, the patient developed right middle cerebral artery infarct for which decompressive hemicraniectomy was done...
March 2018: Neurointervention
Peiying Liu, Ying Qi, Zixuan Lin, Qiyong Guo, Xiaoming Wang, Hanzhang Lu
Abnormal cerebral blood flow (CBF) is implicated in several neonatal and infant diseases. However, measurement of CBF in this population remains difficult and has not been used in routine clinical MRI. Arterial spin labeling (ASL) methods suffer from both low SNR and poor quantification when applied to very young children. Furthermore, rapid change in brain physiology in this age range makes it difficult to choose sequence parameters such as labeling pulse flip angle and post labeling delay. Phase-contrast (PC) MRI is another approach to measure flow...
March 10, 2018: NeuroImage
Giulio Illuminati, Giulia Pizzardi, Rocco Pasqua, Francesca Frezzotti, Piergaspare Palumbo, Francesco Macrina, Francesco Calio
BACKGROUND: Tandem stenoses of the internal carotid artery (ICA) and proximal, ipsilateral common carotid artery (CCA) or innominate artery can be treated with a hybrid approach, combining conventional carotid endarterectomy (CEA) and retrograde stenting of the proximal stenosis, through surgical exposure of the carotid bifurcation. The purpose of this study was to evaluate the results of combining eversion CEA with retrograde CCA/innominate artery stenting. MATERIAL AND METHODS: From January 2015 to July 2017, 7 patients, 6 men of a mean age of 72 years (range 59-83 years) underwent simultaneous, retrograde stenting of the proximal CCA/innominate artery and an eversion CEA of the ipsilateral ICA, through surgical exposure of the carotid bifurcation, for severe tandem stenoses...
March 10, 2018: International Journal of Surgery
Karl-Heinz Deeg
Prenatal, neonatal meningoencephalitis and infections of the brain in older infants are often associated with serious complications which can be diagnosed by sonography through the open fontanelles. Most frequently postmeningitic hydrocephalus and subdural effusions occur. Rarer complications are brain abscesses and ventriculitis which are caused by gram negative bacteria such as E. coli, Serratia marcescens, Proteus and Enterobacter. A serious complication after ventriculitis is the development of compartment hydrocephalus...
March 13, 2018: Ultraschall in der Medizin
Zhu Zhang, Jun-Wei Gong, Ming Wen, Li-Qiang Zhang
Objective To assess the value of internal carotid artery stenosis in differentiating invasive pituitary adenoma (IPA) from invasive meningiomas (IM). Methods The clinical and imaging data of 28 IPA patients and 15 IM patients who were treated in our center from January 2012 to December 2016 were retrospectively analyzed. The magnetic resonance imaging (MRI) features were analyzed. The narrowest diameter (Dstenosis ) and area (Astenosis ) of internal carotid artery around the tumor were measured by computed tomography angiography (CTA),followed by the calculation of the stenosis score (%stenosis )...
February 28, 2018: Zhongguo Yi Xue Ke Xue Yuan Xue Bao. Acta Academiae Medicinae Sinicae
Naureen Narula, Faraz Siddiqui, Nakul Katyal, Akshay Avula, Michel Chalhoub
Internal carotid artery dissection (ICAD) accounts for 25% of cerebrovascular accidents in young and middle-aged patients. Dissection occurs when the intimal wall of an artery is damaged as a result of trauma or defect. ICAD development after dental work is a relatively uncommon phenomenon. Our study highlights a rare presentation of ICAD that resulted from a direct lidocaine nerve block injection in a patient undergoing pulpotomy for a right maxillary second premolar tooth. We have described the case and reviewed the literature on this rare but potentially life-threatening phenomenon...
January 5, 2018: Curēus
Shigeomi Yokoya, Akihiko Hino, Yukihiro Goto, Youichi Hashimoto, Hideki Oka
BACKGROUND: The headache preceding an intracranial aneurysm (AN) rupture is called a sentinel headache (SH), and it is characterized by a sudden, intense, and persistent headache. As subarachnoid hemorrhage (SAH) often develops within several weeks of SH, its rapid diagnosis and treatment can improve the prognosis. CASE DESCRIPTION: A 52-year-old woman with migraine in her medical history visited the outpatient clinic due to left orbital pain. There was no neurological deficit...
March 9, 2018: World Neurosurgery
Midas Meijs, Frank-Erik de Leeuw, Hieronymus D Boogaarts, Rashindra Manniesing, Frederick Jan Anton Meijer
BACKGROUND: In case of carotid artery occlusion, the risk and extent of ischemic cerebral damage is highly dependent on the pathways of collateral flow, including the anatomy of the circle of Willis. In this report, cases are presented to illustrate that 4D-CTA can be considered as a non-invasive alternative to DSA for the evaluation of circle of Willis collateral flow. CASE DESCRIPTION: Five patients with unilateral internal carotid artery (ICA) occlusion underwent 4D-CTA for the evaluation of intracranial hemodynamics...
March 9, 2018: World Neurosurgery
Dong Zhang, Pengcheng Xu, Hongyu Qiao, Xin Liu, Liangping Luo, Wenhua Huang, Heye Zhang, Changzheng Shi
BACKGROUND: Cerebrovascular events are frequently associated with hemodynamic disturbance caused by internal carotid artery (ICA) stenosis. It is challenging to determine the ischemia-related carotid stenosis during the intervention only using digital subtracted angiography (DSA). Inspired by the performance of well-established FFRct technique in hemodynamic assessment of significant coronary stenosis, we introduced a pressure-based carotid arterial functional assessment (CAFA) index generated from computational fluid dynamic (CFD) simulation in DSA data, and investigated its feasibility in the assessment of hemodynamic disturbance preliminarily using pressure-wired measurement and arterial spin labeling (ASL) MRI as references...
March 12, 2018: Biomedical Engineering Online
Tigran Khachatryan, Marina Khachatryan, Ruben Fanarjyan, Mikayel Grigoryan, Arthur Grigorian
Background: Currently, transsphenoidal surgery (TSS) is the preferred method for surgical treatment of intrasellar pituitary adenomas. However, it carries some risk of intraoperative arterial injuries, which is mainly attributed to direct iatrogenic rupture of the internal carotid artery (ICA). There is anecdotal evidence suggesting that intracranial aneurysms are coincidentally found significantly more frequently in the setting of pituitary adenomas than when the incidence is compared to other intracranial neoplasms...
2018: Surgical Neurology International
Tomohide Yoshie, Toshihiro Ueda, Tatsuro Takada, Shinji Nogoshi, Fumio Miyashita, Satoshi Takaishi, Takayuki Fukano, Daiki Tokuura, Yasuhiro Hasegawa
BACKGROUND: Faster time to recanalization leads to better clinical outcomes in patients treated with endovascular thrombectomy. Whether the association between time to recanalization and clinical outcomes depends on cerebral blood volume (CBV) obtained from pretreatment computed tomography (CT) perfusion (CTP) imaging was investigated. METHODS: In consecutive patients with acute ischemic stroke who achieved recanalization by endovascular thrombectomy for intracranial internal carotid artery or M1 occlusion, the effects on clinical outcome of time to recanalization and the relative CBV value (rCBV) assessed by pretreatment CTP were evaluated...
March 7, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
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