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Muñoz A, De Vergas J, Crespo J. Imaging and clinical findings in patients with aberrant course of the cervical internal carotid arteries. Open Neuroimag J. 2010;4:174-81doi: 10.2174/1874440001004010174.
Muñoz, A., De Vergas, J., & Crespo, J. (2010). Imaging and clinical findings in patients with aberrant course of the cervical internal carotid arteries. The open neuroimaging journal, 4174-81. https://doi.org/10.2174/1874440001004010174
Muñoz, Alberto, et al. "Imaging and clinical findings in patients with aberrant course of the cervical internal carotid arteries." The open neuroimaging journal vol. 4 (2010): 174-81. doi: https://doi.org/10.2174/1874440001004010174
Muñoz A, De Vergas J, Crespo J. Imaging and clinical findings in patients with aberrant course of the cervical internal carotid arteries. Open Neuroimag J. 2010 Nov 05;4:174-81. doi: 10.2174/1874440001004010174. PMID: 21283647; PMCID: PMC3026334.
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Open Neuroimag J. 2010 Nov 05;4:174-81. doi: 10.2174/1874440001004010174.

Imaging and clinical findings in patients with aberrant course of the cervical internal carotid arteries.

The open neuroimaging journal

Alberto Muñoz, Joaquín De Vergas, José Crespo

Affiliations

  1. Dpto. de Radiología, Facultad de Medicina, Ciudad Universitaria, Pabellón II, Planta 1ª, 28040, Madrid, Spain.

PMID: 21283647 PMCID: PMC3026334 DOI: 10.2174/1874440001004010174

Abstract

BACKGROUND AND PURPOSE: Aberrrant course of the cervical internal carotid arteries (ICAs) may result in submucosal masses in the posterior pharyngeal wall, may cause confusion at physical examination, may be symptomatic, and can be at risk of surgical injury. The aim of this report is to present the clinical and imaging characteristics associated with aberrant course of the cervical portion of the ICAs.

METHODS: Imaging studies of 5.500 patients were prospectively selected from CT studies of the head and neck performed in a five years period, in which the course of the one or both ICAs at the level of the hypopharynx and oropharynx was assessed as aberrant by means of a proposed classification. We then reviewed the medical records to establish which symptoms were present and if these symptoms could be caused by these variations in the course of the ICAs. In selected cases, further studies including magnetic resonance (MR) imaging, MR angiography (MRA), or selective catheter angiography were obtained.

RESULTS: In our restricted classification, we found 14 (0.2%) patients who met the cervical ICA aberrancy criteria. In all patients contrast enhanced CT or CT angiography was performed, 4 also have had MRI and MRA, and in two additional catheter angiograms were performed. Mean age was 62 years. Eight patients were male and seven were female. Four patients (28%) were considered to have clinical symptoms related to aberrant course of the ICAs. In most of the symptomatic patients both ICAs had aberrant courses. Overall, the course of the right ICA was aberrant in 43%, the left ICA in 14%, and both in 43%. In 50% of the cases the aberrancy of the artery was focal (localized to the oropharynx or laryngopharynx) and in the other 50% it involved the entire cervical course of the ICA.

CONCLUSIONS: In most of our patients variations in the course of the cervical portion of the ICA involved the right side and were asymptomatic, except with regard to potential surgical risks. However, in about 25% of our patients these variations were thought to be the culprit of patient complaints, particularly oropharyngeal pulsatile sensation. Furthermore, extreme degrees of medialization of the ICAs resulted in progressive symptoms including hoarseness and upper respiratory distress.

Keywords: Internal carotid artery; aberrancy; anomalies; carotid artery.; head and neck; internal carotid artery

References

  1. Surg Forum. 1958;9:721-4 - PubMed
  2. Stroke. 1994 Jun;25(6):1201-6 - PubMed
  3. Surgery. 1975 Jan;77(1):45-52 - PubMed
  4. Neurology. 1965 Jan;15:7-18 - PubMed
  5. Laryngoscope. 2008 Nov;118(11):1931-6 - PubMed
  6. Surg Neurol. 1986 May;25(5):478-86 - PubMed
  7. AJNR Am J Neuroradiol. 2001 May;22(5):864-6 - PubMed
  8. Am J Surg. 1985 May;149(5):651-5 - PubMed
  9. AJR Am J Roentgenol. 1996 Nov;167(5):1305-7 - PubMed
  10. Am J Surg. 1977 Jul;134(1):82-9 - PubMed
  11. N Y State J Med. 1960 Apr 15;60:1239-41 - PubMed
  12. Rev Otoneuroophtalmol. 1978 Jan-Feb;50(1):95-8 - PubMed
  13. Dev Med Child Neurol. 1970 Dec;12(6):797-9 - PubMed
  14. Neuroradiology. 1992;35(1):55-6 - PubMed
  15. South Med J. 1988 Nov;81(11):1382-5 - PubMed
  16. Eur Radiol. 1999;9(2):347-8 - PubMed
  17. HNO. 1996 Apr;44(4):178-85 - PubMed
  18. Ann Surg. 1977 Jun;185(6):684-91 - PubMed
  19. J Anat. 2000 Oct;197 Pt 3:373-81 - PubMed
  20. Eur Arch Otorhinolaryngol. 2007 Dec;264(12):1483-9 - PubMed
  21. Angiology. 1952 Dec;3(6):483-92 - PubMed
  22. Br Heart J. 1939 Oct;1(4):345-61 - PubMed
  23. S Afr Med J. 1948 Mar 27;22(6):230-3 - PubMed
  24. Arch Neurol. 1961 Feb;4:119-31 - PubMed
  25. Ann Intern Med. 1956 May;44(5):1003-7 - PubMed
  26. Surgery. 1988 Sep;104(3):568-71 - PubMed
  27. Trans Am Acad Ophthalmol Otolaryngol. 1970 Nov-Dec;74(6):1146-54 - PubMed
  28. Surgery. 1978 Dec;84(6):793-802 - PubMed
  29. Arch Surg. 1984 Apr;119(4):405-9 - PubMed
  30. Geriatrics. 1963 Apr;18:272-5 - PubMed
  31. Br J Surg. 1976 Nov;63(11):847-50 - PubMed

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