Long segment dolichoectasia of the right internal carotid artery diagnosed by CT angiography

Abstract

Dolichoectasia of the cerebral artery, a rare disorder of arterial dilatation, elongation, and tortuosity, most frequently involves the vertebrobasilar system in elderly patients with hypertension and is associated with the development of atherosclerosis in the aging process. Dolichoectasia also can be seen in the carotid system, but it is usually seen at the intracranial short segment of the internal carotid artery (ICA) or anterior cerebral artery. We present a case of dolichoectasia of the long segment of the right internal carotid artery that extended from the upper cervical to terminal segment of the vessel that was diagnosed by computed tomography angiography in a normotensive 66-year-old woman with transient ischemic attack.

Cervical Carotid Artery Dolichoectasia as a Marker of Increased Vascular Risk

“…Isolated cCA DE has been associated with recurrent ischemic stroke and transient ischemic attack (TIA), predominantly in Asian populations. [4][5][6][7][8] The proposed stroke mechanism in this setting includes decreased blood flow and stagnation, 9,10 with subsequent thrombus formation within the dilated segment of the artery. 11,12 Because of the limited availability of data related to cCA DE, we carried out a review of the literature to identify knowledge gaps and research opportunities that may help elucidate the role cCA DE plays in the risk of vascular events and cerebrovascular disease.…”

“…Although cCA DE has been understudied, clinical data suggest that it may be an important determinant of vascular risk and vascular events. Isolated cCA DE has been associated with recurrent ischemic stroke and transient ischemic attack (TIA), predominantly in Asian populations 4–8 . The proposed stroke mechanism in this setting includes decreased blood flow and stagnation, 9,10 with subsequent thrombus formation within the dilated segment of the artery 11,12 …”