Prevalence of internal carotid artery morphological variations and its association with cerebrovascular ischemic stroke (hospital-based study)

Abstract

Background and objectives: Morphological variations (MV) in the course of the internal carotid artery (ICA) are commonly identified. Their prevalence and relationship with ischemic stroke (IS) remain unclear. The present study attempted to estimate the prevalence and pattern of MV of ICA among Egyptian patients and to detect whether these MV associated with increased risk of IS or not. Methods: Out of the recruited 550 acute ischemic stroke patients, 102 met the inclusion and exclusion criteria and were included in our study. Each patient was subjected to detailed history including risk factors and clinical assessment using the National Institute of Health Stroke Scale, mRS, and extracranial duplex ultrasound (US) assessment. Results: Eleven patients out of 102 (10.8%) showed MV in their ICA course, 6 of them were women and 5 were men. These MV were unilateral in 90.9% (10/11) of cases and more in the left ICA (72.7%), while one case (9.1%) showed MV of both ICA. The commonest pattern of MV was tortuosity in 7 cases (63.6%) and kinking in 4 cases (36.4%). The history of previous IS and TIA was recorded in 9.1% of patients with MV in ICA for each group, while the history of IS was recorded in 13.2% of patients without MV and TIA in 4.3% patients without MV in ICA. There were no statistically significant differences between both groups. Conclusion: The prevalence of MV in the present study is 10.8%. MV are more frequent in women and older patients and are not associated with an increased risk of ischemic stroke.