No abstract available.
Carotid Artery, Internal ; Carotid Artery, Internal, Dissection ; Osteogenesis Imperfecta

Carotid arterial dissections may result from spontaneous or traumatic causes. Postcoital arterial dissections have been reported in both the vertebral and coronary arteries. We report a rare case of spontaneous dissection on the extracranial internal carotid artery in a Filipino female after sexual intercourse, leading to a fulminant middle cerebral artery (MCA) territory infarct. Although postcoital carotid artery dissection is a very rare cause of neck vessel dissections, its rapid progressive course can lead to massive cerebral infarction and prompt management must be initiated.
Cerebral Infarction ; Carotid Artery, Internal, Dissection

The sternocleidomastoid (SCM) artery supplying blood to the SCM muscle has different origins according to its anatomical segment. The authors performed cadaveric neck dissection to review the surgical anatomy of neurovascular structures surrounding the carotid artery in the neck. During the dissection, an unusual finding was cited in which the SCM artery supplying the middle part of the SCM muscle originated from the lingual artery (LA); it was also noted that it crossed over the hypoglossal nerve (HN). There have been extremely rare reports citing the SCM artery originated from the LA. Though the elevation of the HN over the internal carotid artery was relatively high, the vascular loop crossing over the HN was very close to the carotid bifurcation. Special anatomical consideration is required to avoid the injury of the HN during carotid artery surgery.
Arteries ; Cadaver ; Carotid Arteries ; Carotid Artery, Internal ; Crossing Over, Genetic ; Hypoglossal Nerve ; Muscles ; Neck ; Neck Dissection

We describe a technique to clip a large internal carotid artery (ICA) aneurysm via a retrograde suction decompression (RSD). A large aneurysm in the right distal ICA involving the bifurcation region measuring 1.2×1.1×0.7 cm with posterior projection was managed with assisted RSD technique. The anterior choroidal artery emerged from the side wall of the aneurysm. An Inahara shunt was inserted into the ICA with neck dissection, and RSD was applied after completely clipping the aneurysm. RSD with an Inahara carotid shunt is useful for complete visualization of the aneurysm, including its surrounding structures, and for proximal control of the parent vessels, subsequently achieving satisfactory clip placement.
Aneurysm* ; Arteries ; Carotid Arteries ; Carotid Artery, Internal* ; Choroid ; Decompression* ; Humans ; Intracranial Aneurysm ; Neck Dissection ; Parents ; Suction*

Angiography, Digital Subtraction ; Arterial Occlusive Diseases ; diagnosis ; Carotid Artery Diseases ; diagnosis ; Carotid Artery, Internal ; pathology ; Carotid Artery, Internal, Dissection ; diagnosis ; Humans ; Male ; Middle Aged

Extracranial carotid artery dissection may manifest as arterial stenosis or occlusion, or as dissecting aneurysm formation. Anticoagulation and/or antiplatelet therapy is the first-line treatment, but because it is effective and less invasive than other procedures, endovascular treatment of carotid artery dissection has recently attracted interest. We encountered two consecutive cases of traumarelated extracranial internal carotid artery dissection, one in the suprabulbar portion and one in the subpetrosal portion. We managed the patient with suprabulbar dissection using a self-expandable metallic stent and managed the patient with subpet-rosal dissection using a balloon-expandable metallic stent. In both patients the dissecting aneurysm disappeared, and at follow-up improved luminal patency was observed.
Adult ; Carotid Artery Injuries/complications ; Carotid Artery, Internal, Dissection/etiology/radiography/*therapy ; Case Report ; Cerebral Angiography ; Human ; Male ; *Stents

Most intracranial saccular aneurysms arise from the distal angle between a parent vessel and an arterial branch. We present three cases of saccular aneurysms arising from the unbranched-site of the dorsal wall of the intracranial internal carotid artery(ICA) total of 162 ICA aneurysms(1.9%). All three cases presented with sudden onset of headache and mental deterioration. Computerized tomography(CT) scans revealed typical pattern of aneurysmal subarachnoid hemorrhage. With transfemoral cerebral angiography(TFCA) dorsal wall aneurysms were easily detected except one case, which we missed small bulging at unusual site on initial TFCA. Second TFCA of this particular case a definite aneurysmal dilatation at dorsal wall of intracranial ICA. The operative findings disclosed darkish red entirely thin-walled aneurysms pointing to the sylvian cistern, attached to either temporal lobe or optic nerve. In two cases aneurysms were ruptured during neck dissection. The authors emphasize the pathogenesis and surgical points of this particular type of aneurysm with review of patient literatures.
Aneurysm* ; Carotid Artery, Internal* ; Dilatation ; Headache ; Humans ; Neck Dissection ; Optic Nerve ; Parents ; Subarachnoid Hemorrhage ; Temporal Lobe

Adult ; Carotid Artery, Internal, Dissection ; diagnosis ; Female ; Hematoma ; diagnosis ; Humans ; Ultrasonography ; methods

Carotid Artery, Internal, Dissection ; therapy ; Humans ; Male ; Middle Aged ; Treatment Outcome

Aneurysms arising remote from arterial divisions are rare. From January 1981 to December 1993, We operated on 271 internal carotid artery aneurysms(ICAA). Among them, we found nine of such unusual aneurysms protruding from the dorsal(six cases) or medical wall(three cases) of the internal carotid artery. Angiographically, they were often misdiagnosed as the posterior communicating artery aneurysms or carotid artery bifurcation aneurysm due to small size and flat shape with broad neck. On operation, all three medical wall aneurysms showed severe atherosclerosis. and moderate to minimal atherosclerosis was found in four dorsal wall aneurysms. In four cases, we experienced intraoperative premature rupture of the aneurysm, one during retraction of the frontal lobe due to adhesion of the aneurysmal dome to the base of frontal lobe, two during aneurysmal neck dissection and the other one during clip application. These aneurysms were difficult to operate on because of their fragility(thin or atherosclerotic wall) and relatively board aneurysmal neck. In conclusion, these aneurysms presented with difficulties in preoperative diagnosis by angiography due to small size and flat shape. In operation, special care should be taken to avoid premature rupture of the aneurysm due to thin or atherosclerotic fragile wall.
Aneurysm* ; Angiography ; Atherosclerosis ; Carotid Arteries ; Carotid Artery, Internal* ; Diagnosis ; Frontal Lobe ; Intracranial Aneurysm ; Neck ; Neck Dissection ; Rupture