Abnormal Internal Carotid Artery Kinking in a Cadaver: Morphogenesis and a Potential Link to Alzheimer's Disease

We report the case of a 95-year-old female cadaver with a documented history of Alzheimer's disease (AD) and an anteroinferior kinking of the right internal carotid artery (ICA). On dissection, the right ICA bifurcated at the superior one-third of C3 and demonstrated a marked kink with an inferior deviation of 45° followed by superior redirection of 60°, consistent with morphologic criteria for kinking. A digital caliper was used to obtain vessel measurements. The right ICA lumen measured 4.2 mm in diameter with a focal wall thickness of 2.5 mm, exceeding the Mannheim consensus plaque threshold of 1.5 mm and consistent with advanced atherosclerosis. No histologic sections were available to confirm carotid plaque composition, and the diagnosis of AD was based on past medical history without neuropathologic staging. Nevertheless, the coexistence of severe ICA kinking and extensive plaque formation raises the possibility that chronic vascular insufficiency contributed to the decedent's cognitive decline. This interpretation remains speculative, particularly in the context of advanced age and likely coexisting vascular risk factors. This case underscores the importance of recognizing congenital and acquired ICA anomalies during morphologic and clinical evaluation. Quantitative assessment of ICA variation may help refine diagnostic considerations in dementia and support further investigation into the vascular contributions to neurodegeneration.