Related Experiment Videos
[Study of the hypoplasic internal carotid artery by use of multislice spiral computed tomography. Two case reports]
B Ibarra de Grassa1, F J Romero-Vidal, M M Alarcón-Alcaraz
1Servicio de Nurorradiología. Institute de Diagnòstic per la Imatge. Hospital General Vall d'Hebron, Barcelona, España.
Insights
Hypoplastic internal carotid artery (HICA) is a rare condition. Helical computerized tomography (HCT) effectively diagnosed HICA and associated findings in two patients, offering a comprehensive imaging solution.
Area of Science:
- Neurology
- Radiology
- Vascular Malformations
Background:
- Hypoplastic internal carotid artery (HICA) is a rare congenital anomaly.
- The carotid string sign on angiography can indicate various conditions requiring different treatments.
- Accurate diagnosis is crucial for appropriate patient management.
Observation:
- Two cases of HICA are presented, diagnosed using helical computerized tomography (HCT).
- Case 1 involved a patient with Chiari I malformation and syringomyelia, revealing an hypoplastic posterior fossa and right carotid foramen.
- Case 2 featured an elderly patient with stroke symptoms, showing HCT findings of carotid artery stenosis, occlusion, and an hypoplastic right carotid artery.
Findings:
- Multislice HCT enabled volumetric study and diagnosis of HICA in both cases.
- HCT identified associated anomalies such as hypoplastic posterior fossa and carotid foramen.
- The carotid string sign was visualized via HCT angiography.
Implications:
- Helical computerized tomography is a valuable tool for diagnosing hypoplastic internal carotid artery.
- HCT can diagnose HICA without the need for additional imaging studies.
- This imaging modality aids in differentiating HICA from other conditions presenting with the carotid string sign.
Introduction:
Hypoplastic internal carotid artery (HICA) is a rare benign congenital malformation. Its angiographic image string sign is shared by entities that may be either medically or surgically treated. We report two cases diagnosed by helical computerized tomography (HCT).
Case Reports:
Case 1: woman diagnosed clinically and by magnetic resonance (MR) of Chiari I malformation with associated syringomyelia. An HCT of the craniocervical junction was done to rule out osseous malformations. An hypoplastic posterior fossa (PF) with small right carotid foramen was diagnosed. An arteriography with HCT was done that showed the carotid string sign. Case 2: a 82 years old hypertensive woman with left hemiparesia and homonymous hemianopsia was diagnosed of right temporooccipital infarct. An HCT arteriography disclosed occlusion of the right posterior cerebral artery, calcification of the left carotid siphon and stenosis of the right siphon. Bi and tridimensional reconstructions of the circle of Willis, cranial base and distal cervical carotid arteries showed an hypoplastic right carotid artery and foramen.
Conclusions:
Multislice HCT is a recently incorporated diagnostic tool that allows a volumetric study in a short period of time, seconds. An angiographic study can be done intravenously in cases of vascular anomaly suspiction, hypoplastic carotid artery in the reported cases. HCT is the only current imaging tool that can diagnose this anomaly without the aid of other imaging studies.