Spontaneous bilateral carotid artery dissection in a patient with bovine aortic arch

Area of Science:

• Vascular Surgery
• Neurology
• Anatomical Pathology

Background:

• Carotid artery dissections are a significant cause of ischemic stroke, particularly in younger individuals.
• These dissections are often linked to trauma or connective tissue disorders.
• Anatomical variations of the aortic arch, such as the bovine aortic arch, are typically considered asymptomatic.

Observation:

• A rare case of spontaneous dissection involving the common origin of the innominate and left common carotid arteries was observed.
• This dissection occurred in a patient with a bovine aortic arch anatomical variant.
• The dissection led to bilateral involvement of the carotid arteries.

Findings:

• This presentation represents the first documented instance of spontaneous dissection originating from the common trunk of the innominate and left common carotid artery in the context of a bovine aortic arch.
• The bovine aortic arch variant was implicated as a potential contributing factor to the dissection's origin and bilateral extension.
• The findings challenge the assumption that the bovine aortic arch variant is without physiological consequence in cerebrovascular events.

Implications:

• This case underscores the importance of considering anatomical variations like the bovine aortic arch in the etiology of cerebrovascular dissections.
• It suggests a potential link between the bovine aortic arch and spontaneous carotid artery dissection, warranting further investigation.
• Recognizing this association may improve diagnostic accuracy and patient management for cerebrovascular dissections, especially in younger populations.