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Long segment dolichoectasia of the right internal carotid artery diagnosed by CT angiography
Akira Uchino1, Shinya Kohyama2
1Department of Diagnostic Radiology, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, Saitama 350-1298, Japan.
Insights
Dolichoectasia, a rare arterial condition, typically affects older individuals. This case highlights a unique long-segment dolichoectasia of the internal carotid artery in a normotensive woman presenting with transient ischemic attack.
Area of Science:
- Neurology
- Vascular Medicine
- Radiology
Background:
- Cerebral artery dolichoectasia is a rare vascular disorder characterized by arterial dilatation, elongation, and tortuosity.
- It most commonly affects the vertebrobasilar system in elderly, hypertensive patients, often linked to atherosclerosis.
- Carotid system involvement is less common, usually limited to short segments of the internal carotid artery (ICA) or anterior cerebral artery.
Observation:
- This report details an unusual case of extensive dolichoectasia.
- The condition involved a long segment of the right internal carotid artery, extending from the upper cervical to the terminal portions.
- The patient was a 66-year-old woman with no history of hypertension.
Findings:
- Computed tomography angiography (CTA) confirmed the diagnosis of dolichoectasia.
- The extensive nature of the dolichoectasia in the internal carotid artery was a key finding.
- The patient presented with symptoms of a transient ischemic attack.
Implications:
- This case expands the understanding of dolichoectasia presentation, particularly in the carotid system.
- It underscores the importance of advanced imaging like CTA in diagnosing rare vascular anomalies.
- Further research may elucidate risk factors and optimal management for such extensive dolichoectatic segments.
Abstract:
Dolichoectasia of the cerebral artery, a rare disorder of arterial dilatation, elongation, and tortuosity, most frequently involves the vertebrobasilar system in elderly patients with hypertension and is associated with the development of atherosclerosis in the aging process. Dolichoectasia also can be seen in the carotid system, but it is usually seen at the intracranial short segment of the internal carotid artery (ICA) or anterior cerebral artery. We present a case of dolichoectasia of the long segment of the right internal carotid artery that extended from the upper cervical to terminal segment of the vessel that was diagnosed by computed tomography angiography in a normotensive 66-year-old woman with transient ischemic attack.
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