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Internal carotid artery narrowing in children with retropharyngeal lymphadenitis and abscess
P A Hudgins1, J H Dorey, I N Jacobs
1Department of Radiology, Emory University School of Medicine, Atlanta, GA 30322, USA.
Insights
Retropharyngeal abscesses in children can cause significant narrowing of the internal carotid artery (ICA). However, this ICA narrowing is a common, benign finding and does not lead to neurological deficits.
Area of Science:
- Pediatric Radiology
- Vascular Imaging
- Infectious Disease Imaging
Background:
- Retropharyngeal abscesses are serious infections in children.
- Internal carotid artery (ICA) narrowing can occur adjacent to these abscesses.
Purpose of the Study:
- To investigate the association between internal carotid artery (ICA) narrowing and retropharyngeal abscess in pediatric patients.
- To determine if ICA narrowing in this context is clinically significant.
Main Methods:
- Retrospective analysis of neck CT scans from 13 children with retropharyngeal abscess.
- Evaluation of ICA diameter asymmetry at the abscess level.
- Prospective analysis of 20 control CT scans for normal ICA dimensions.
Main Results:
- Significant diameter reduction (mean 3 mm vs. 5 mm) of the ICA ipsilateral to the abscess was observed.
- ICA diameters in control subjects were symmetrical.
- All affected children remained neurologically normal.
Conclusions:
- Internal carotid artery (ICA) narrowing adjacent to retropharyngeal abscesses in children is a common imaging finding.
- This narrowing appears to be benign and incidental, with no observed neurological deficits.
- Further investigation into the implications of this finding is warranted.
Background And Purpose:
Our purpose was to describe the association between narrowing of the internal carotid artery (ICA) and retropharyngeal abscess in children.
Methods:
Neck CT scans from 13 consecutive children with suppurative retropharyngeal lymphadenitis and abscess were evaluated retrospectively for asymmetric ICA diameters at the level of the abscess. Clinical status at the time of illness was established via a chart review. Twenty control CT scans obtained from pediatric patients with normal imaging findings were evaluated prospectively to determine symmetry and size of the ICA.
Results:
Mean diameter of the normal ICA, contralateral to the retropharyngeal abscess, was 5 mm (range, 3-8 mm), while mean diameter ipsilateral to the abscess was 3 mm (range, 1-5 mm). The diameters of the normal and abnormal ICAs were statistically significantly different. All children were neurologically normal. The right and left ICAs in children with normal CT findings in the neck were symmetrical in diameter.
Conclusion:
Despite dramatic narrowing of the ICA ipsilateral to retropharyngeal lymphadenitis and abscess, no children in this series had neurologic deficits, suggesting that such narrowing is a common, benign, and, most likely, incidental imaging finding.