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.

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