Bilateral variations in the branching of the external carotid artery: a case report

Various anatomical variations in the branching pattern of the external carotid arteries are known to occur with significant frequency and have been documented in published literature. The purpose of this case report is to document and discuss variations in the branching patterns of the external carotid artery as seen in an anatomical donor and determine the clinical relevance of these variations.

A routine dissection of an 89-year-old female anatomical donor, whose cause of death was reported as acute myocardial infarction and atherosclerotic heart disease, revealed variations in the branching patterns of both external carotid arteries. Bilaterally, the common carotid arteries bifurcated at the C4 vertebral level. On the left side, an occipitoauricular trunk originated 0.5 mm superior to the common carotid artery's bifurcation, whereas, on the right side, an occipitoauriculopharyngeal trunk branching 0.8 mm superior to the bifurcation of the common carotid artery was observed before branching into an occipitoauricular trunk and ascending pharyngeal artery.

This case report reinforces previous publications on arterial branching patterns and the importance of imaging prior to procedures. Clinically, these variations may impact surgical approaches, endovascular procedures within the neck, and vascular pathology management.