Familial Hypoplasia of Both Internal Carotid Arteries

Austin, James H.; Stears, John C.

doi:10.1001/archneur.1971.00480310029001

Cited by 27 publications

(6 citation statements)

References 14 publications

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“…The hypoplastic arteries may either continue intracranially or become occluded at some intracranial point; often they lead into the ophthalmic arteries [10,14]. In our case, the hypoplastic arteries also terminated as the ophthalmic arteries bilaterally.…”

Section: Discussionmentioning

confidence: 65%

Bilateral hypoplasia of the internal carotid artery, presenting as a subarachnoid hemorrhage secondary to intracranial aneurysmal formation: a case report

Siddiqui

Sobani

2012

J Med Case Reports

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IntroductionHypoplasia of the internal carotid artery is a rare congenital anomaly, with only 24 cases of bilateral internal carotid artery hypoplasia reported to date. Here, we present the case of a 48-year-old woman with bilateral internal carotid artery hypoplasia. She had a collateral circulation through the vertebrobasilar system; however given the high pressure flow she developed aneurysmal formations in the posterior communicating artery. To the best of our knowledge, only seven reported cases of internal carotid artery hypoplasia have been associated with intracranial aneurysmal formations.Case presentationA 48-year-old Sindhi woman from Karachi, Pakistan, presented to our emergency room with a sudden onset headache and was diagnosed as having a subarachnoid hemorrhage. Digital subtraction angiography revealed hypoplasia of her internal carotid artery bilaterally with an associated fusiform aneurysm of the posterior communicating artery. Our patient declined any operative intervention in view of the associated risks. She died of a rebleed six weeks after her initial presentation.ConclusionBilateral internal carotid artery occlusions can present with subarachnoid hemorrhages due to associated intracranial aneurysm formation. Prior knowledge about the possible existence of such angioarchitectural arrangement is mandatory for an early diagnosis. However, even with prompt diagnosis, management options with acceptable risk-benefit equations are still unavailable.

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Section: Discussionmentioning

confidence: 65%

Bilateral hypoplasia of the internal carotid artery, presenting as a subarachnoid hemorrhage secondary to intracranial aneurysmal formation: a case report

Siddiqui

Sobani

2012

J Med Case Reports

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“…Alternatively, both carotid hypoplasia and aneurysm for mation may represent associated congenital defects. Iden tifying ICA hypoplasia may also have diagnostic implica tions in cases of acute stroke, because ICA hypoplasia is occasionally revealed by hemorrhagic [3,4,8,13] or less often ischemic strokes [2,7], Intracerebral or subarach noid hemorrhage may be related to an associated vascular malformation or to the rupture of thin-walled and fragile anastomotic arteries [1]. The mechanism o f ischemic events complicating ICA hypoplasia is more speculative, although it has been suggested that ICA hypoplasia could Carotid Canal Diameter in Internal Carotid Artery Hypoplasia predispose to some degree o f hemodynamic disturbances [3], Although the angiographic pattern of a regular and extended narrowing of the ICA beyond a normal initial segment is suggestive o f ICA hypoplasia [1][2][3]8], more common ICA diseases such as atherosclerosis, dissection, retrograde throm bus from a distal occlusion or arteritis may occasionally provide a similar radiological picture [6].…”

Section: Resultsmentioning

confidence: 99%

“…The mechanism o f ischemic events complicating ICA hypoplasia is more speculative, although it has been suggested that ICA hypoplasia could Carotid Canal Diameter in Internal Carotid Artery Hypoplasia predispose to some degree o f hemodynamic disturbances [3], Although the angiographic pattern of a regular and extended narrowing of the ICA beyond a normal initial segment is suggestive o f ICA hypoplasia [1][2][3]8], more common ICA diseases such as atherosclerosis, dissection, retrograde throm bus from a distal occlusion or arteritis may occasionally provide a similar radiological picture [6]. The presence of an associated 'rete m irabile' anasto motic network on angiography is very suggestive of some congenital abnorm ality [7,8,15], but this pattern is inconstant. Unusual angiographic presentations of ICA hypoplasia, such as a gradual tapering of the lumen diam eter [2,5], may also lead to diagnostic misinterpretations.…”

Section: Resultsmentioning

confidence: 99%

CT Scan of the Skull Base in Internal Carotid Artery Hypoplasia

Kubis¹,

Zuber²,

Méder³

et al. 1995

Cerebrovasc Dis

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Internal carotid artery (ICA) hypoplasia is a rare congenital anomaly that is sometimes difficult to distinguish from acquired diseases associated with narrowing of the ICA. As the carotid canal develops in association with the ICA, a hypoplastic carotid artery should result in a hypoplastic carotid canal. We used skull base CT scans to measure the size of carotid canals in 4 patients with ICA hypoplasia (bilateral in 1) and in 30 consecutive controls. The diameter of the carotid canal was significantly smaller in the patients with carotid hypoplasia (2.4–3.0 mm, on the involved side) than in the controls (mean = 6.4 ± 0.8 mm, range = 5.2–9.8 mm) with no overlapping value (p < 0.001). The ratio of the largest to the smallest carotid diameter was greater than 2 in patients with unilateral hypoplasia, while it never exceeded 1.2 in controls. CT scan of the skull base is a simple and reliable tool for confirming the diagnosis of ICA hypoplasia.

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“…18) Table 1 summarizes the 26 reported cases including our present case. [1][2][3][4][5][6][7][8][9][10][11][12][13][15][16][17][18][19][20][21][22][23] The age of the patients ranged from 2 to 68 years (mean 41.1 years). Twelve of these cases occurred in Japanese patients.…”

Section: Discussionmentioning

confidence: 99%

Carotid Rete Mirabile Associated With Subarachnoid Hemorrhage-Case Report-

Mikami

Takahashi

Houkin

2005

Neurol. Med. Chir.(Tokyo)

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A 47-year-old man presented with carotid rete mirabile manifesting as subarachnoid hemorrhage (SAH). Computed tomography showed SAH, and angiography disclosed an abnormal vascular network around the petrous and cavernous portions of the internal carotid artery. Single photon emission computed tomography (SPECT) with technetium-99m methyl cysteinate dimer revealed reduced regional cerebral blood flow (CBF). Twelve months later, he was leading a normal life without neurological problems, hemorrhage, or ischemic manifestations. SPECT with iodine-123 N-isopropyl-p-iodoamphetamine and the acetazolamide challenge test showed the CBF had normalized.

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Familial Hypoplasia of Both Internal Carotid Arteries

Cited by 27 publications

References 14 publications

Bilateral hypoplasia of the internal carotid artery, presenting as a subarachnoid hemorrhage secondary to intracranial aneurysmal formation: a case report

Bilateral hypoplasia of the internal carotid artery, presenting as a subarachnoid hemorrhage secondary to intracranial aneurysmal formation: a case report

CT Scan of the Skull Base in Internal Carotid Artery Hypoplasia

Carotid Rete Mirabile Associated With Subarachnoid Hemorrhage-Case Report-

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