Skip to main content
Log in

Isolation of right internal carotid artery, persistent proatlantal 1 artery and rete mirabile in a child with 22q11 deletion syndrome

  • Case Report
  • Published:
Child's Nervous System Aims and scope Submit manuscript

Abstract

We report a case of a 2-year-old girl with 22q11 deletion syndrome who underwent studies for cardiac murmur. Ultrasound, computed tomography angiography and digital subtraction angiography revealed an aberrant right subclavian artery and an isolated right internal carotid artery (ICA) originating from the right pulmonary artery. A right carotid rete mirabile (CRM) and a proatlantal (Pa) type 1 artery were also found. We hypothesize that Pa type 1 persistence and CRM development are secondary to the reversal of flow of the isolated ICA.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Basset Anne S et al (2011) Practical guidelines for managing patients with 22q11.2 deletion syndrome. J Pediatr 159(2):332–339.e1

    Article  Google Scholar 

  2. Ahmadi A, Sabri M, Dehghan B (2015) An isolated left common carotid artery from the main pulmonary artery in a neonate with aortic valve atresia. Cardiol Young 25(6):1193–1196. https://doi.org/10.1017/S1047951115000475

    Article  PubMed  Google Scholar 

  3. Onyekachukwu O, Blaise J, Russel H (2016) Anomalous origin of the left common carotid artery from the main pulmonary artery: a rare association in an infant with CHARGE syndrome. Case Rep Pediatr 2016:2064937, 4 pages. https://doi.org/10.1155/2016/2064937

    Article  Google Scholar 

  4. Hurley MC, Nguyen PH, DiPatri AJ, Shaibani A (2008) Isolated origin of the left internal carotid artery from the pulmonary artery. J Neurosurg Pediatrics 2:207–211

    Article  Google Scholar 

  5. Huang SF, Wu MH (1996) Left common carotid artery arising from the pulmonary artery in a patient with DiGeorge syndrome. Heart 76(1):82–83

    Article  CAS  Google Scholar 

  6. Fong LV, Venables AW (1987) Isolation of the left common carotid or left innominate artery. Br Heart J 57:552–554

    Article  CAS  Google Scholar 

  7. Idhrees AM et al (2015) A shunt from the brain: left internal carotid artery arising from the left pulmonary artery in tetralogy of Fallot. Ann Thorac Surg 99(2):e47–e49

    Article  Google Scholar 

  8. Fouilloux V, Gran C, Kreitmann B (2013) Isolated left common carotid artery connected to the pulmonary artery: where was the arterial duct? World J Pediatr Congenital Heart Surg 4(2):229–232. https://doi.org/10.1177/2150135112473614

    Article  Google Scholar 

  9. Kaushik N, Saba Z, Rosenfeld H et al (2005) An isolated left common carotid artery from the main pulmonary artery: possible malseptation of the truncoaortic sac. Pediatr Cardiol 26(5):707–709

    Article  CAS  Google Scholar 

  10. Thankavel P, Martho L, Zeltser I (2016) Anomalous left pulmonary artery origin from internal carotid artery: prospective echocardiographic diagnosis of a previously unknown variant. Cardiol Young 26(1):139–142. https://doi.org/10.1017/S1047951115000384

    Article  PubMed  Google Scholar 

  11. Lie TA (1968) Congenital anomalies of the carotid arteries: including the carotid-basilar and carotid-vertebral anastomosis. An angiographic study and a review of the literature. Excerpta Med, Amsterdam

    Google Scholar 

  12. Herwadkar A (2006) A case of carotid rete mirabile associated with basilar tip aneurysm. Interv Neuroradiol 12:161–164

    Article  CAS  Google Scholar 

  13. Lin E, Linfante I, Dabus G (2013) Unilateral rete mirabile as a result of segmental agenesis of the ascending petrous segment of the internal carotid artery: embryology, differential diagnosis and clinical implications. Interv Neuroradiol 19:73–77

    Article  CAS  Google Scholar 

  14. Karasawa J, Touho H, Ohnishi H et al (1997) Rete mirabile in humans—case report. Neurol Med Chir (Tokyo) 37(2):188–192. https://doi.org/10.2176/nmc.37.1

    Article  CAS  Google Scholar 

  15. Paschoal EH, Yamaki VN, Júnior FM, Piske RL, Teixeira MJ, Bor-Seng-Shu E (2015) Carotid rete mirabile associated with subarachnoid hemorrhage from intracranial aneurysm: a case report and systematic review. Interv Neuroradiol 21(1):55–60. https://doi.org/10.15274/INR-2014-10107

    Article  PubMed  PubMed Central  Google Scholar 

  16. Henkes H, Reinartz J, Fischer S et al (2007) Rete mirabile bei segmentaler agenesie der A. carotis interna. Nervenarzt 78(8):948–953. https://doi.org/10.1007/s00115-007-2260-x

    Article  CAS  PubMed  Google Scholar 

  17. Lu J, Liu J, Wang L et al (2014) Bilateral segmental agenesis of carotid and vertebral arteries with rete mirabile and the prominent anterior and posterior spinal arteries as compensations. Interv Neuroradiol 20:13–19. https://doi.org/10.15274/INR-2014-10003

    Article  PubMed  PubMed Central  Google Scholar 

  18. Tozzi R, Hernanz-Schulman M, Kiley R et al (1989) Congenital pulmonary steal associated with tetralogy of Fallot, right aortic arch and an isolated left carotid artery. Pediatr Radiol 19(6–7):449–451. https://doi.org/10.1007/BF02387653

    Article  CAS  PubMed  Google Scholar 

  19. Horowitz M, Bansal S, Dastur K (2003) Aortic arch origin of the left external carotid artery and type II proatlantal fetal anastomosis. AJNR 24(3):323–325

    PubMed  Google Scholar 

  20. Krings T, Geiprasert S, Cruz JP, terBrugge K (2015) Neurovascular anatomy in interventional neuroradiology. A case based approach. Thieme, New York

    Google Scholar 

  21. Bahsi YZ, Uysal H, Peker S, Yurdakul M (1993) Persistent primitive proatlantal intersegmental artery (proatlantal artery 1) results in “top of the basilar” syndrome. Stroke 24:2114–2117

    Article  CAS  Google Scholar 

  22. Anderson RA, Sondheimer FK (1993) Rare carotid-vertebrobasilar anastomoses with notes on differentiation between proatlantal and hypoglossal arteries. Neuroradiology 117:232–238

    Google Scholar 

  23. Saito N, Uchino A, Ishihara S (2013) Complex anomalies of type 1 proatlantal intersegmental artery and aortic arch variations. Surg Radiol Anat 35:177–180. https://doi.org/10.1007/s00276-012-1017-9

    Article  PubMed  Google Scholar 

  24. Männer J, Seidl W, Steding G (1997) The formal pathogenesis of isolated common carotid or innominate arteries: the concept of malseptation of the aortic sac. Anat Embryol (Berl) 196:435–445

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Flavio Requejo.

Ethics declarations

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Informed consent

Informed consent was obtained from all individuals participating for whom identifying information is included in this article.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Requejo, F., Strawich, F.R., Mouratian, D.M. et al. Isolation of right internal carotid artery, persistent proatlantal 1 artery and rete mirabile in a child with 22q11 deletion syndrome. Childs Nerv Syst 34, 2509–2513 (2018). https://doi.org/10.1007/s00381-018-3910-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00381-018-3910-y

Keywords

Navigation