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Rare congenital anomalies of the internal carotid artery: anatomic and radiologic aspects of three cases and review of the literature

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Abstract

Purpose

Congenital anomaly of the internal carotid artery (ICA) is a rare entity. It is usually discovered incidentally by color doppler carotid sonography, angiography, computerized tomography (CT), or magnetic resonance imaging of the head and neck region taken for some other reasons. The aim of this study was to detect congenital ICA anomalies, to delineate existing collateral vessels and to find out its incidence.

Methods

1847 patients’ CT angiography images of the head and neck region taken between May 2013 and February 2018 were retrospectively evaluated for ICA anomalies.

Results

We detected three cases (0.16%) with unilateral agenesis of ICA, bilateral agenesis of ICA and bilateral hypoplasia of ICA, respectively. Most patients are asymptomatic because of collateral cerebral circulation supplied by the communicating arteries of the circle of Willis, intercavernous anastomosis, communicating arteries from the external carotid artery, and by persistent embryologic arteries to the carotid artery territory.

Conclusion

Recognition of ICA anomalies has important implications during planned carotid or transsphenoidal surgery, in thromboembolic disease, and in the follow-up and detection of associated cerebral aneurysms.

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References

  1. Agnoli AL (1982) Vascular anomalies and subarachnoid haemorrhage associated with persisting embryonic vessels. Acta Neurochir (Wien) 60:183–199. https://doi.org/10.1007/bf01406306

    Article  CAS  Google Scholar 

  2. Alexandre AM, Visconti E, Schiarelli C, Frassanito P, Pedicelli A (2016) Bilateral internal carotid artery segmental agenesis: embryology, common collateral pathways, clinical presentation, and clinical importance of a rare condition. World Neurosurg 95:620.e629–620.e615. https://doi.org/10.1016/j.wneu.2016.08.012

    Article  Google Scholar 

  3. Cohen JE, Gomori JM, Leker RR (2010) Internal carotid artery agenesis: diagnosis, clinical spectrum, associated conditions and its importance in the era of stroke interventions. Neurol Res 32:1027–1032. https://doi.org/10.1179/016164110X12767786356273

    Article  PubMed  Google Scholar 

  4. Curtis AG, Huang-Hellinger F, Baker MD, Chepuri NB, Morris PP (2001) Congenital absence of the internal carotid artery: case reports and review of the collateral circulation. Am J Neuroradiol 22:1953–1959

    Google Scholar 

  5. Czarnecki EJ, Silbergleit R, Mehta BA, Sanders WP (1998) Absence of the supraclinoid internal carotid artery in association with intracranial aneurysms. Neuroradiology 40:11–14

    Article  CAS  Google Scholar 

  6. Damry N, Hanquinet S, Christophe C, Janssen F, Delatte P, Perlmutter N (1994) Bilateral congenital absence of the internal carotid artery with a primitive transmaxillary arterial anastomosis. Pediatr Radiol 24:200–203

    Article  CAS  Google Scholar 

  7. Fields WS (1968) The significance of persistent trigeminal artery. In: Carotid-basilar anastomosis Radiol vol 91. pp 1095–1101

  8. George AE, Lin JP, Morantz RA (1971) Intracranial aneurysm on a persistent primitive trigeminal artery. Case report. J Neurosurg 35:601–604. https://doi.org/10.3171/jns.1971.35.5.0601

    Article  CAS  PubMed  Google Scholar 

  9. Hattori T, Kobayashi H, Inoue S, Sakai N (1998) Persistent primitive trigeminal artery associated with absence of internal carotid artery. Surg Neurol 50:352–355

    Article  CAS  Google Scholar 

  10. Hong JH, Chang HW, Kim JM, Cho HC, Kim SH, Hong JH, Kim SJ, Jeong HW (2016) Internal carotid artery agenesis associated with a rare collateral pathway: supraclinoid–supraclinoid anastomosis. A case report. Surg Radiol Anat 38:261–263. https://doi.org/10.1007/s00276-015-1531-7

    Article  PubMed  Google Scholar 

  11. Ito S, Miyazaki H, Iino N, Shiokawa Y, Saito I (2005) Unilateral agenesis and hypoplasia of the internal carotid artery: a report of three cases. Neuroradiology 47:311–315. https://doi.org/10.1007/s00234-003-1090-1

    Article  CAS  PubMed  Google Scholar 

  12. Lasjaunias P, Berenstein A, Brugge KG (2001) Surgical neuroangiography-clinical vascular anatomy and variations, vol 1. 2nd edn. Springer, New York

  13. Lasjaunias P, Santoyo-Vazquez A (1984) Segmental agenesis of the internal carotid artery: angiographic aspects with embryological discussion. Anat Clin 6:133–141

    Article  CAS  Google Scholar 

  14. Lee JH, Oh CW, Lee SH, Han DH (2003) Aplasia of the internal carotid artery. Acta Neurochir (Wien) 145:117–125. https://doi.org/10.1007/s00701-002-1046-y

    Article  Google Scholar 

  15. Lhermitte F, Gautier JC, Poirier J, Tyrer JH (1968) Hypoplasia of the internal carotid artery. Neurology 18:439–446. https://doi.org/10.1212/wnl.18.5.439

    Article  CAS  PubMed  Google Scholar 

  16. Li S, Hooda K, Gupta N, Kumar Y (2017) Internal carotid artery agenesis: a case report and review of literature. Neuroradiol J 30:186–191. https://doi.org/10.1177/1971400917692162

    Article  PubMed  PubMed Central  Google Scholar 

  17. Lie T, Hage J (1968) Congenital anomalies of the carotid arteries. Plast Reconstr Surg 42:283

  18. Mellado JM, Merino X, Ramos A, Salvado E, Sauri A (2001) Agenesis of the internal carotid artery with a trans-sellar anastomosis: CT and MRI findings in late-onset congenital hypopituitarism. Neuroradiology 43:237–241

    Article  CAS  Google Scholar 

  19. Midkiff RB, Boykin MW, McFarland DR, Bauman JA (1995) Agenesis of the internal carotid artery with intercavernous anastomosis. Am J Neuroradiol 16:1356–1359

    CAS  PubMed  Google Scholar 

  20. Osborn A (1999) Diagnostic cerebral angiography, 2nd edn. Lippincott Williams & Wilkins, Philadelphia

    Google Scholar 

  21. Pascual-Castroviejo I, Viano J, Pascual-Pascual SI, Martinez V (1995) Facial haemangioma, agenesis of the internal carotid artery and dysplasia of cerebral cortex: case report. Neuroradiology 37:692–695

    Article  CAS  Google Scholar 

  22. Pilleul F, Guiband L, Badinand N, Rouviere O, Pracros JP (2001) Bilateral internal carotid agenesis: value of CT angiography and correlation to embryogenesis. Eur Radiol 11:858–860

    Article  CAS  Google Scholar 

  23. Sadler TW (2006) Langman’s Medical Embryology, 10th edn. Lippincott Williams & Wilkins, Philadelphia

    Google Scholar 

  24. Sliwka U, Schmidt P, Reul J, Noth J (1998) Agenesis of the internal carotid artery: color doppler, CT, and MR angiography findings. J Clin Ultrasound 26:213–216

    Article  CAS  Google Scholar 

  25. Sunada I, Inoue T (1996) Bilateral internal carotid artery agenesis. J Neurol Neurosurg Psychiatry 61:206–207

    Article  CAS  Google Scholar 

  26. Taşar M, Yetişer S, Taşar A, Uğurel Ş, Gönül E, Sağlam M (2004) Congenital absence or hypoplasia of the carotid artery: radioclinical issues. Am J Otolaryngol 25:339–349. https://doi.org/10.1016/j.amjoto.2004.04.008

    Article  PubMed  Google Scholar 

  27. Wang PJ, Liu HM, Young C, Lin MY, Shen YZ (1994) Agenesis of internal carotid artery associated with symptomatic partial epilepsy. Epilepsia 35:1337–1341. https://doi.org/10.1111/j.1528-1157.1994.tb01808.x

    Article  CAS  PubMed  Google Scholar 

  28. Zink WE, Komotar RJ, Meyers PM (2007) Internal carotid aplasia/hypoplasia and intracranial saccular aneurysms: series of three new cases and systematic review of the literature. J Neuroimaging 17:141–147. https://doi.org/10.1111/j.1552-6569.2007.00092.x

    Article  PubMed  Google Scholar 

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Acknowledgements

The authors would like to thank Ms. Hale Akdemir (DT) for illustrations.

Funding

No funding was received.

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Authors and Affiliations

  1. Faculty of Medicine, Department of Anatomy, Hacettepe University, Ankara, Turkey

    Hilal Akdemir Aktaş & Ayşegül Fırat

  2. Faculty of Medicine, Department of Anatomy, Ufuk University, Ankara, Turkey

    Mine Farımaz

  3. Faculty of Medicine, Department of Radiology, Hacettepe University, Ankara, Turkey

    Rahşan Göçmen

Authors
  1. Hilal Akdemir Aktaş
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  2. Mine Farımaz
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  3. Ayşegül Fırat
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  4. Rahşan Göçmen
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Contributions

HAA: Project development, data collection, manuscript writing. MF: Data collection, manuscript writing. AF: Project development, data analysis, manuscript writing and editing. RG: Data analysis, manuscript editing.

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Correspondence to Hilal Akdemir Aktaş.

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Akdemir Aktaş, H., Farımaz, M., Fırat, A. et al. Rare congenital anomalies of the internal carotid artery: anatomic and radiologic aspects of three cases and review of the literature. Surg Radiol Anat 42, 1363–1370 (2020). https://doi.org/10.1007/s00276-020-02549-w

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  • DOI: https://doi.org/10.1007/s00276-020-02549-w

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