Kinking of Bilateral Internal Carotid Arteries as Cause of Cognitive Dysfunction

Amidzic, Amel; Tiro, Naida

doi:10.5455/medarh.2020.74.58-60

Cited by 5 publications

(1 citation statement)

References 12 publications

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“…It has been postulated that the variant led to decreased cerebral blood flow and cognitive decline. Kinking can also lead to syncope when the neck is turned abruptly, as was seen in our patient [11]. Del Corso L et al showed that patients with ICA abnormalities, including kinking, tortuosity, and coiling, have a low association with stroke or atherosclerotic vascular disease [12].…”

Section: Discussionsupporting

confidence: 62%

Tortuous Carotid Arteries and Their Clinical Implications: A Report of Two Cases

Raidah¹,

Jaramillo²,

Serena³

et al. 2023

Cureus

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The tortuous carotid artery is a rare anatomic abnormality defined as vascular elongation leading to an altered course. It can be discovered incidentally or have clinically significant manifestations. The most common location is the internal carotid artery or, less commonly, the common carotid artery. Bilateral tortuous carotid arteries can also occur, leading to "kissing carotids" where the carotid arteries are juxtaposed. We describe two cases of carotid artery tortuosity in patients with risk factors associated with its development. One case is of a 91-year-old female presenting with a cerebrovascular accident and an incidental finding of tortuosity of the right common carotid artery mimicking the appearance of "kissing carotids." The other case concerns a 66-year-old female with a symptomatic tortuous left internal carotid artery. This report aims to inform clinicians of the differences in the anatomical features, pathogenesis, and possible clinical implications of these variants.

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Section: Discussionsupporting

confidence: 62%

Tortuous Carotid Arteries and Their Clinical Implications: A Report of Two Cases

Raidah¹,

Jaramillo²,

Serena³

et al. 2023

Cureus

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Additional ultrasound capabilities for local haemodynamically significant carotid deformity: a one-stage observational study

Поморцев

Baghdasaryan

2022

Kuban. nauсh. med. vestnik

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Background. Despite a wide range of studies, no consensus has been reached on the relative weight of ultrasound parameters for assessing local haemodynamically significant carotid deformations.Objectives. To estimate a diagnostic value for an additional multiparametric ultrasound parameter for local haemodynamically significant carotid deformations.Methods. In the first phase, 388 patients underwent an outpatient multiparametric ultrasound examination of the carotid arteries. The study involved patients of the age of 18 and older with a primary referral for carotid ultrasound by a resident physician, neurologist or cardiologist in order to rule out a carotid pathology. As a supplement to the main haemodynamic significance assessment parameters, we introduced an additional metric — the deformity coefficient – in order to diagnose carotid abnormalities. Based on the first phase results, two cohorts were selected. Cohort 1 (control) consisted of patients with no abnormalities in multiparametric carotid ultrasound. Cohort 2 consisted of patients with isolated unilateral internal carotid artery deformities at no haemodynamically significant stenosis of common and internal carotid arteries in multiparametric carotid ultrasound. In the second phase, the patients underwent transcranial duplex sonography of the middle cerebral arteries, in order to detect regional haemodynamically significant internal carotid artery deformities.Results. Mathematical modelling of abnormal arteries produced the empirical upper deformity coefficient thresholds to distinguish acute angulation. This value is >1.41 for C-shaped and >1.34 — for S-shaped curves.Subsequent statistical analysis revealed a clear positive correlation between angulation and the deformity coefficient at a p < 0.01 significance level. More acute angulation corresponds to higher coefficient values.The Spearman correlation between the deformity coefficient and blood flow asymmetry values for middle cerebral artery was 0.89. This defines a significant positive correlation (higher deformity coefficient corresponds to higher blood flow asymmetry) at a p < 0.01 significance level.Conclusion. The deformity coefficient is an additional ultrasound parameter for assessing local haemodynamically significant carotid abnormalities.

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Analysis of the correlations between the extracranial internal carotid artery and extracranial vertebral artery and mild cognitive impairment

Yin,

Zhao,

Gao

et al. 2024

THC

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BACKGROUND: Vascular tortuosity is a prevalent morphological change that frequently occurs in arteries across different parts of the body. OBJECTIVE: To analyze the relationship between the tortuosities of the extracranial internal carotid artery (EICA) and extracranial vertebral artery (EVA) with mild cognitive impairment. METHODS: The tortuosity index (TI), vascular deviation degree, tortuosity degree, and angle number of the EICA and EVA were retrospectively analyzed and calculated in 160 patients who underwent computed tomography angiography (CTA) in this study’s department, and the Montreal cognitive assessment was adopted to evaluate the cognitive function of the patients. RESULTS: The differences in age, gender, arterial hypertension (AH), and diabetes mellitus (DM) between the normal group and the mild cognitive impairment group were statistically significant (p< 0.01). The TI was negatively correlated with the score of cognitive function. The tortuosities of the EICA and EVA were correlated with mild cognitive impairment (p< 0.05). The reduction in visual-spatial ability was correlated with the right EICA tortuosity, and the reduction in memory was correlated with the EVA tortuosity. Age, gender, HP, DM, and coronary heart disease (CHD) were potential risk factors for carotid tortuosity (p< 0.05). CONCLUSION: There was a significant correlation observed between the TIs of both the EICA and EVA and the presence of mild cognitive impairment. Advanced age, female, HP, DM, and CHD were independent risk factors for EICA and EVA tortuosities.

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Kinking of Bilateral Internal Carotid Arteries as Cause of Cognitive Dysfunction

Cited by 5 publications

References 12 publications

Tortuous Carotid Arteries and Their Clinical Implications: A Report of Two Cases

Tortuous Carotid Arteries and Their Clinical Implications: A Report of Two Cases

Additional ultrasound capabilities for local haemodynamically significant carotid deformity: a one-stage observational study

Analysis of the correlations between the extracranial internal carotid artery and extracranial vertebral artery and mild cognitive impairment

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