Imaging of nonatheromatous carotid artery disease

Abstract

Imaging diagnosis of nonatheromatous carotid artery disease is challenging due to its low prevalence in contrast to that of atheromatous disease. Congenital anomalies are frequently discovered incidentally, as the chronicity of these conditions allows for compensatory flow development. The inflammatory conditions typically present with nonspecific courses, and a high clinical suspicion along with timely imaging evaluation can guide the diagnosis. Carotid dissection is the result of a partial disruption of the arterial wall and can be seen in previously healthy patients, in patients with underlying noninflammatory arteriopathies or trauma. Traumatic injuries to the carotid artery may occur under many different conditions and mechanisms and timely recognition of high-risk patients improves patient outcomes. Although free-floating thrombi (FFT) formation is typically seen with atherosclerotic plaque rupture, different conditions may also predispose to FFT. In this review article, we study the different imaging features of nonatheromatous carotid artery disease using ultrasonography, computed tomography angiography, magnetic resonance angiography, and digital subtraction angiogram.

Internal carotid artery agenesis disclosed by carotid ultrasonography

“…Intracranial circulation in the involved internal carotid artery territory is supplied by the contralateral carotid artery and from the vertebrobasilar circulation through the anterior and posterior communicating arteries, respectively 2 . Complete absence of bony carotid canal helps to differentiate agenesis from aplasia or hypoplasia 3 . Although most AICA patients remain asymptomatic, they may present with headache, cerebral infarcts, transient ischemic attacks, epilepsy, intracranial aneurysm, and amaurosis fugax 1,4 .…”

“…2 Complete absence of bony carotid canal helps to differentiate agenesis from aplasia or hypoplasia. 3 Although most AICA patients remain asymptomatic, they may present with headache, cerebral infarcts, transient ischemic attacks, epilepsy, intracranial aneurysm, and amaurosis fugax. 1,4 Hereby, we want to share our experiences to apply color Doppler ultrasound to a patient with repeated cerebrovascular events in order to make an early diagnosis.…”