A rare combination of carotid artery congenital abnormalities: understanding the embryology and clinical associations

Abstract

Duplication of an extracranial internal carotid artery, a retropharyngeal carotid transposition, an aberrant internal carotid artery in the middle ear, and a persistent stapedial artery are each individually uncommon vascular variants. In this case report, we discuss a rare occurrence of all four of these variants in a single individual who presented to our emergency department with a complaint of dizziness and a recent fall. Included in the discussion is pertinent embryology and clinical associations.

Stenting in the Remnant of the Third Aortic Arch in a Case of Post-Irradiation Occluded Internal Carotid Artery

“…the other anatomical variations of the cervical ICa include fenestration, duplication, or aberrant course development 10,11 . In cases involving fenestration, there is no discrepancy between the two components of the common trunk.…”

Two cases of combined anatomical variations: maxillofacial trunk, vertebral, posterior communicating and anterior cerebral atresia, linguofacial and labiomental trunks

“…During embryogenesis of the pharyngeal system six paired aortic arches develop bilaterally between primitive ventral and dorsal aortae [21]. The dorsal remnants of the first embryonic aortic arch coalesce with the hyoid artery which emerges the second aortic arch to form the hyostapedial artery [31].…”

Duplication of the Extracranial Internal Carotid Artery Analyzed by MRI

“…Duplication must be differentiated from dissection as well as fenestration, the latter referring generally to a shorter segment. In the scientific literature, ICA duplication has been described by Killien et al in 1980 2 , and then by Chess et al in 1995 3 , and McEachen et al in 2008, in association with other developmental anomalies 4 .…”