Статті в журналах: "Internal carotid arteries"

1

Ewida, Amr, Rashid Ahmed, Anqi Luo, and Hesham Masoud. "Spontaneous dissection of bilateral internal carotid and vertebral arteries." BMJ Case Reports 14, no. 3 (March 2021): e241173. http://dx.doi.org/10.1136/bcr-2020-241173.

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Spontaneous dissection of the major arteries of the neck is known to increase the risk of stroke or transient ischaemic attack in young and middle-aged adults. Most of the reported cases of arterial dissections in the neck involve one or both paired extracranial carotid or vertebral arteries. Spontaneous dissection of the bilateral internal carotid and vertebral arteries is extremely rare. We report a case of spontaneous bilateral internal carotid artery and vertebral artery dissection while using a prescribed pill for weight loss which contained amphetamine derivative. A review of literature is also provided.

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2

Ashikaga, R., Y. Araki, and O. Ishida. "Bilateral aberrant internal carotid arteries." Neuroradiology 37, no. 8 (November 1, 1995): 655–57. http://dx.doi.org/10.1007/s002340050172.

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3

Campbell, Gregory, Gregory Renner, and Scott A. Estrem. "Bilateral Aberrant Internal Carotid Arteries." Otolaryngology–Head and Neck Surgery 107, no. 1 (July 1992): 124–28. http://dx.doi.org/10.1177/019459989210700121.

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4

Ashikaga, R., Y. Araki, and O. Ishida. "Bilateral aberrant internal carotid arteries." Neuroradiology 37, no. 8 (November 1995): 655–57. http://dx.doi.org/10.1007/bf00593385.

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5

Broalet, Maman You Espérance, Abenin Samson Assi, Djibril Ouattara, and Némé Antoine Tako. "Anatomical study of the internal carotid artery of the aulacode (Thryonomys swindérianus, Temminck 1827)." Anatomy Journal of Africa 11, no. 2 (December 8, 2022): 2212–17. http://dx.doi.org/10.4314/aja.v11i2.9.

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The arterial circle at the base of the skull appears to be supplied only by the vertebrobasilar system. The anatomy of the internal carotid artery is not known. The aim of this study was to contribute to a better understanding of the anatomy of the arterial system of the aulacode. A total of twelve (12) carotid arteries from six (6) grasscutters were injected with neoprene latex to study the origin, path, termination, collateral branches and brain irrigation areas of the. internal carotid artery. Originating from the common carotid artery, the internal carotid arteries, right and left, flowed forward and out to reach the lateral surfaces of the trachea. In the cervical region, they emitted three collateral branches, the posterior laryngeal artery, the artery of the neck muscles, and the encephalic artery. These different arteries supplied the larynx, neck and brain, respectively. The encephalic arteries were either single or double. The arteries of the neck muscles were dividing at their endings or not. The observation of the latex in the brain reflects the participation of the internal carotid artery in the vascularization of the brain, or at least of anastomoses between its branches and those of the external carotid artery or the vertebro-basilar system.

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6

Kawai, Yasuaki, Shin Yokoyama, and Toshio Ohhashi. "Time-dependent potentiation of contractile response to norepinephrine in canine isolated cerebral arteries." Canadian Journal of Physiology and Pharmacology 69, no. 12 (December 1, 1991): 1889–95. http://dx.doi.org/10.1139/y91-279.

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The time course of contractile responses to α-adrenoceptor agonists was investigated using various arteries isolated from dogs and monkeys. The contractile response to norepinephrine was increased during the time course of the experiment in canine basilar and internal carotid arteries, whereas the response of isolated canine external carotid arteries and monkey internal carotid arteries did not change significantly. Treatment with 10−7 M propranolol, 5 × 10−6 M cocaine plus 10−5 M hydrocortisone, or 5 × 10−5 M acetylsalicylic acid did not significantly affect the time-dependent potentiation of the norepinephrine-induced contraction in canine internal carotid arteries. The time-dependent enhancement in the response to norepinephrine was also observed in the arterial preparations from which the endothelial cells were removed. The contractile response of canine internal carotid arteries to phenylephrine did not alter significantly throughout the experiments. On the other hand, the responses to clonidine and xylazine were markedly enhanced with time. Significant potentiation of the norepinephrine-induced contraction was observed in canine internal carotid arteries treated with 10−8 M prazosin, whereas 10−8 M yohimbine attenuated the time-dependent potentiation. These results suggest that the contractile responses of isolated canine basilar and internal carotid arteries to norepinephrine are potentiated during the course of the experiment, which is likely to be related, in part, to an enhancement in α2-adrenoceptor mediated contraction.Key words: α2-adrenoceptor, dog, cerebral artery, enhancement of contraction, vascular smooth muscle.

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7

Kadhum, Khalid Kamil. "Study of the blood supply of the brain in sheep." Iraqi Journal of Veterinary Medicine 23, no. 1 (June 28, 1999): 59–66. http://dx.doi.org/10.30539/ijvm.v23i1.1192.

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The brain of the sheep receives its blood supply through the carotid rete and the basilar artery. The carotid rete formed of contribution of internal carotid artery and branches from maxillary artery. The internal carotid artery courses on the ventral surface of the cerebal crus to give the rostral cerebal artery and the caudal communicating artery . Thus , arteries excepted the middle cerebal artery forming with the same arteries of the opposite side , the cerebal arterial circle or circle of Willis. The internal caroted artery also gives off hypophysialartery to the 1999 ind, (1) swell, ügymielly wel dati', il pellilendiambell ileti hypophysis. The caudal communicating artery give off the caudal cerebal artery and the rostral cerebellar artery and unite with the corresponding artery of the opposite side to form the basilar artery rostral to the pone . The basilar artery gives off the pontine artery , caudal cerebellar artery and the medullary branch.

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8

Ziemak, H., H. Frackowiak, and M. Zdun. "Domestic cat’s internal carotid artery in ontogenesis." Veterinární Medicína 66, No. 7 (June 1, 2021): 292–97. http://dx.doi.org/10.17221/116/2020-vetmed.

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The aim of the study was to trace the presence of the internal carotid artery in the system of cerebral arteries of the domestic cat and to determine the role of this artery in supplying blood to the brain in ontogenesis. The available publications provide ambiguous or even contradictory information. The authors of some studies claim that there is no extracranial segment in the domestic cat’s internal carotid artery. Other authors reported the internal carotid artery in the arterial pattern of the encephalon base. The study was conducted on sixty-one domestic cats: fifteen foetuses, sixteen juvenile cats, and thirty adult cats were analysed. The internal carotid artery – a vessel with a relatively large lumen – was fully preserved in all the foetuses and most of the juvenile animals. This artery was not complete with regard to the adults and some juvenile individuals, because it had lost the extracranial segment as a result of the obliteration process. A precise description of this area is not only of biological, but also of clinical, significance. The knowledge of the anatomical structure of cerebral vessels is particularly important to correctly interpret images obtained during diagnostic tests and to conduct surgical procedures correctly.

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9

Lučev, Natalija, Dragica Bobinac, Ivana Marić, and Ivan Drešćik. "Variations of the great arteries in the carotid triangle." Otolaryngology–Head and Neck Surgery 122, no. 4 (April 2000): 590–91. http://dx.doi.org/10.1067/mhn.2000.97982.

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The variations of the common carotid artery, as well as of the external and internal carotid arteries, are described. During anatomic dissection on adult cadavers, we investigated the variability of appearance of 40 carotid arterial systems. Special consideration was given to the topographic relations such as the level of the bifurcation of the common carotid artery, the relationship between the external and internal carotid arteries, and the origin of the great collateral branches. Special attention was paid to the origin of the superior thyroid artery. In this article the practical importance of these variations is stressed.

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10

Altay, Sedat. "Imaging of Aberrant Internal Carotid Arteries." Journal of Computer Assisted Tomography 45, no. 4 (June 28, 2021): 614–17. http://dx.doi.org/10.1097/rct.0000000000001177.

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11

Mokri, Bahram. "SPONTANEOUS DISSECTIONS OF INTERNAL CAROTID ARTERIES." Neurologist 3, no. 2 (March 1997): 104–19. http://dx.doi.org/10.1097/00127893-199703000-00005.

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12

Shanley, D. J. "Bilateral aberrant cervical internal carotid arteries." Neuroradiology 35, no. 1 (1992): 55–56. http://dx.doi.org/10.1007/bf00588280.

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13

Schlenska, G. K. "Absence of both internal carotid arteries." Journal of Neurology 233, no. 5 (October 1986): 263–66. http://dx.doi.org/10.1007/bf00314156.

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14

Echefu, Gift, Rameela Mahat, Raju Vatsavai, and Steven Zuckerman. "Spontaneous Dissections of Bilateral Internal Carotid and Vertebral Arteries due to Intractable Vomiting." Case Reports in Vascular Medicine 2022 (April 11, 2022): 1–5. http://dx.doi.org/10.1155/2022/8156047.

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In young adults, spontaneous craniocervical arterial dissections (sCAD), which involve the major arteries of the head and neck, are associated with an increased risk of stroke. sCAD occurs in the absence of major trauma as seen in traumatic craniocervical artery dissection. It may affect unilateral or bilateral carotid or vertebral arteries. Cases of spontaneous bilateral carotid and vertebral artery dissections occurring simultaneously are extremely rare. We present a case of a 49-year-old female with no history of arteriopathy who presented with aphasia and right upper extremity weakness and was found to have dissections in bilateral extracranial and intracranial carotid arteries, as well as the bilateral vertebral arteries. She had symptomatic improvement with antithrombotic therapy and aggressive outpatient rehabilitation.

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15

Ghosh, Anasuya, Subhramoy Chaudhury, and Atin Datta. "Variations, relations and clinical significance of carotid arterial system in anterior neck: a cadaveric study." International Journal of Research in Medical Sciences 7, no. 4 (March 27, 2019): 1127. http://dx.doi.org/10.18203/2320-6012.ijrms20191311.

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Background: The common carotid, internal and external carotid arteries and their branches serve as major source of blood supply in head-neck region of human and are often encountered during numerous surgical and clinical interventions of neck.Methods: We dissected and examined both sides of neck in 49 well embalmed cadavers (98 sides). We recorded the following anatomical parameters of carotid arterial system-level of bifurcation, the relation between internal and external carotid arteries, branching pattern of anterior branches of external carotid artery, tortuosity in carotid arterial system, and relation of hypoglossal nerve with the carotid arteries.Results: In 56.16 % cases, the common carotid arterial bifurcation took place at the upper border of thyroid cartilage though high bifurcation was quite common (43.88%). The external carotid artery was located antero-medial to internal carotid artery in most cases (93.87%). Abnormal tortuosity of carotid arterial system was detected in 2.04% cases only. In 86.73% cases, the hypoglossal nerve crossed the internal and external carotid artery superior to carotid bifurcation above the level of hyoid bone while in 1 case it crossed immediately inferior to carotid bifurcation. In branching pattern, following variations were observed- linguo-facial trunk in 15.3% cases, thyro-lingual trunk in 5.1% cases, origin of superior thyroid artery from common carotid in 10.02% cases and origin of superior thyroid from internal carotid in one case (1.02%).Conclusions: The carotid arterial system has complex and variable anatomy in neck and this information should be kept in mind to avoid unwanted damage during surgical procedures of neck.

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16

Chen, H. C., C. J. Lin, F. C. Chang, C. B. Luo, Y. J. Lai, and C. Y. Chang. "Stenting in the Remnant of the Third Aortic Arch in a Case of Post-Irradiation Occluded Internal Carotid Artery." Interventional Neuroradiology 17, no. 1 (March 2011): 22–26. http://dx.doi.org/10.1177/159101991101700105.

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Collateral networks between the external carotid artery and internal carotid arteries become crucial for cerebral perfusion after occlusion of internal carotid arteries. We report the first case of a patient who received percutaneous transluminal angioplasty and stenting in a collateral vessel between the external and internal carotid artery for treatment of radiation induced severe stenosis of the internal carotid artery in the context of a contralateral internal carotid artery occlusion.

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17

Honda, Masaru, and Hajime Maeda. "Analysis of twisted internal carotid arteries in carotid endarterectomy." Surgical Neurology International 11 (June 13, 2020): 147. http://dx.doi.org/10.25259/sni_601_2019.

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Background: The twisted carotid artery is a variant, in which the internal carotid artery (ICA) courses medially to the external carotid artery. Due to the sparse descriptions in the literature, we, here, report our experience with cases of carotid endarterectomy (CEA) for twisted carotid artery and its clinical features. Methods: Fifty-seven consecutive CEA-treated patients were evaluated, and the twist angle was measured on the source images of axial slices of computed tomography angiography (CTA). Results: Eight male patients (14.2%) demonstrated a twisted right ICA (mean age, 77.0 ± 2.6 years; and mean stenosis, 66.9% ± 19.9%). The mean twist angle was 30.1° ± 17.9°, while the normal ICA is angled at −23.0° ± 12.3°. No statistical differences in the distribution of coexisting diseases were found between the normal and twisted ICA cases. CEA was successfully performed with the correction of the carotid position in all cases; however, significant position correction was not observed in the postoperative evaluation. Right-side dominancy (P = 0.045) and prolonged clamping time (P = 0.053) were observed in the twisted cases. Conclusion: Twisted ICA was preferentially found in the right ICA and men. CEA of the twisted ICA was safely performed with appropriate head rotation and wider longitudinal skin incision than usual without a significant increase in the operative time. CTA is useful for preoperative evaluation. This specific variation should be considered by the neurosurgeon involved in the evaluation and treatment of carotid stenoses.

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18

Polyakov, Vladimir Ya, Yu A. Nikolaev, S. V. Pegova, T. R. Matsievskaya, and I. V. Obukhov. "Changes of carotid and vertebral arteries in patents with arterial hypertension and hepatobiliary pathology." Clinical Medicine (Russian Journal) 94, no. 1 (February 19, 2016): 39–42. http://dx.doi.org/10.18821/0023-2149-2016-94-1-39-42.

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The study included 1172patients (410 men and 762 women) at the mean age of 60.3±10.4years with grade I-II (stage I-II) arterial hypertension (AH) admitted to the clinic of Institute of Experimental Medicine. The patients were divided into 2 groups based on the results of clinical and laboratory diagnostics. Group 1 (n=525) included patients with AH and hepatobiliary system (HBS) diseases, group 2 (n=647) patients with AH without HBS diseases. The patients group 1 had a thicker intima-media complex of carotid arteries, higher peak systolic bloodflow rate in the internal and vertebral carotid arteries, more pronounced coiling of internal carotid arteries than patients of group 2. Patients with AH and HBS diseases exhibited correlation between blood flow rate in external carotid arteries and atherogenicity coefficient. Duplex scanning of neck vessels of in patients with AH without HBS diseases revealed peculiar changes of the intima-media thickness and hemodynamically significant changes of the blood flow in the internal carotid arteries that may be of prognostic value in this nosological syntropy and require the personified approach to diagnostics, treatment, and prevention of these conditions.

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19

Homma, Satoki, Gregory D. Sloop, and Arthur W. Zieske. "The Effect of Age and Other Atherosclerotic Risk Factors on Carotid Artery Blood Velocity in Individuals Ranging from Young Adults to Centenarians." Angiology 60, no. 5 (November 17, 2008): 637–43. http://dx.doi.org/10.1177/0003319708325447.

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To evaluate the effect of age and other risk factors for atherosclerosis on arterial blood velocity, carotid arteries in 179 healthy individuals ranging from 21 to 102 years old were examined using color Doppler ultrasonography. Velocity in common and internal carotid arteries decreased consecutively from young adults to very elderly people except for peak internal carotid artery velocity. Peak common carotid artery velocity in the elderly (≥ 65 years old) people was inversely associated with age and diastolic blood pressure and directly associated with pulse pressure. Minimum velocity of common carotid artery was inversely correlated with age and diastolic blood pressure in the elderly people. In elderly group, peak internal carotid artery velocity correlated only with serum high-density lipoprotein cholesterol. Minimum internal carotid artery velocity correlated inversely with systolic blood pressure in adults and diastolic blood pressure in elderly people. Blood velocity in the very elderly population approaches the critical level for thrombogenesis.

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20

Gavrilidou, P., D. M. Iliescu, R. Baz, and P. Bordei. "Morphological characteristics of the external carotid artery." ARS Medica Tomitana 19, no. 2 (May 1, 2013): 74–78. http://dx.doi.org/10.2478/arsm-2013-0013.

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Abstract The morphological characteristics at the level of the bifurcation of the common carotid artery were studied on 46 cases, finding that the most frequent, in 52.17% of cases, the common carotid bifurcation appear as the letter “V”, with two possible variations: a wide “V”, in 43.48% of cases and narrow “V” in 8.7% of cases. In 30.43% of cases, the two carotids showed an ascending traject, united for 1-2 cm up to their crossing; in 13,04% of the cases the two arteries were superimposed, the external located anteriorly. In only in two cases on the right side (4.35% of cases and 8.33% of right samples) we found a peculiar aspect of a “U” shaped bifurcation. Regarding the caliber of the external carotid artery, we found that in 43.33% of the cases the external carotid artery had a similar diameter to the internal carotid, also in 43.33% of the external carotid artery have a higher caliber than internal one and the remaining 13.33% of the cases, the external carotid artery had a smaller diameter than the internal one, with all cases on the left (16.67% of left carotid arteries). The caliber of the right external carotid artery was between 4 to 5.6 mm and the one of the left was between 3.6 to 5 mm. When the external carotid was more voluminous than the internal, the differences were 0.5 to 1.2 mm and when the internal carotid was more voluminous than the external, the differences were smaller, 0.2 to 0.8 mm. In relation to the common carotid, the external carotid had a smaller caliber from 0.6 to 1.1 mm. Regarding the external carotid traject, most commonly, from the bifurcation of the common carotid, the external carotid artery showed a vertical trajectory, in 50% of cases; in 40% of cases, the traject was oblique superomedially and in 6.67% of cases the external carotid artery described a curve with the convexity facing laterally, with all cases on the right (11.76% of right carotid arteries); in 3.33% of cases, both on the left (7.69% of the left carotid arteries), the external carotid artery traject described an inverted italic “S”

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21

Chitra, R. "Trifurcation of the right common carotid artery." Indian Journal of Plastic Surgery 41, no. 01 (January 2008): 85–88. http://dx.doi.org/10.1055/s-0039-1699237.

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ABSTRACTVariations in the position of the bifurcation of the common carotid artery and the origin or branching pattern of the external carotid artery are well known and documented. Here, we report the trifurcation of the right common carotid artery in a male cadaver aged about 55 years. The right common carotid artery was found to divide into the external and internal carotids and the occipital artery. High division of bilateral common carotid arteries and a lateral position of the right external carotid artery at its origin were also observed in the same cadaver. There were two ascending pharyngeal arteries on the right side - one from the occipital artery and another from the internal carotid artery. The intraarterial approach is one of the most important routes for the administration of anticancer drugs for head and neck cancers. A profound knowledge of the anatomical characteristics and variations of the carotid artery such as its branching pattern and its position is essential to avoid complications with catheter insertion.

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22

Rao, S. B., V. R. Vollala, M. Rao, V. P. Samuel, D. Deepthinath, S. Nayak, and N. Pamidi. "Unusual position of external carotid artery: a case report." Indian Journal of Plastic Surgery 38, no. 02 (July 2005): 170–71. http://dx.doi.org/10.1055/s-0039-1699098.

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AbstractThe arterial pattern of the human body is one of the systems that show a large number of variations. Many reports are available regarding variations of common carotid, external and internal carotid arteries and branches of external carotid artery. We describe a very rare case of lateral position of external carotid artery. The external carotid artery was lateral to the internal carotid artery at the bifurcation of the common carotid artery. The clinical importance of this variation is discussed.

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23

Pollanen, M. S., J. H. N. Deck, B. Blenkinsop, and E. M. Farkas. "Fracture of Temporal Bone With Exsanguination: Pathology and Mechanism." Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques 19, no. 2 (May 1992): 196–200. http://dx.doi.org/10.1017/s0317167100042256.

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ABSTRACT:Eight cases of basal skull fracture with transverse fracture of the petrous temporal bone with medial extension to the internal carotid artery and lateral extension of the structures of the middle ear are described. Injuries in all cases were due to major blunt impact to the head usually occurring in a motor vehicle accident. General autopsy revealed major blood loss without any obvious external or internal site of hemorrhage suggesting that exsanguination was a complication of the head injury. The internal carotid arteries at the most medial extension of the fractures were lacerated or transected in all cases. In selected cases, the cervical internal carotid arteries were perfused and perfusate escaped rapidly from the ear(s) with the majority of fluid bypassing the cerebral venous system. Magnetic resonance image reconstruction of sequential sections of the fractured base of the skull confirmed the laceration of the internal carotid arteries and disruption of the middle ear. Based on this evidence, we propose that some displaced fractures of the base of the skull produce carotid-middle ear continuities which act as arterial shunts, resulting in rapid fatal exsanguination through the ear.

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24

Brudnicki, W., B. Skoczylas, R. Jablonski, W. Nowicki, A. Brudnicki, K. Kirkillo-Stacewicz, and J. Wach. "The arteries of the brain base in the degu (Octodon degus Molina 1782)." Veterinární Medicína 59, No. 7 (September 16, 2014): 343–48. http://dx.doi.org/10.17221/7621-vetmed.

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The brain arteries derived from 50 adult degu individuals of both sexes were injected with synthetic latex introduced with a syringe into the left ventricle of the heart under constant pressure. After fixation in 5% formalin and brain preparation, it was found that the sources of the brain’s supply of blood are vertebral arteries and the basilar artery formed as a result of their anastomosis. The basilar artery gave rise to caudal cerebellar arteries and then divided into two branches which formed the arterial circle of the brain. The internal carotid arteries in degus, except for one case, were heavily reduced and did not play an important role in the blood supply to the brain. The arterial circle of the brain in 48% of the cases was open from the rostral side. Variation was identified in the anatomy and the pattern of the arteries of the base of the brain in the degu which involved an asymmetry of the descent of caudal cerebellar arteries (6.0%), rostral cerebellar arteries (8%) as well as middle cerebral arteries (12%). In 6% of the individuals double middle cerebral arteries were found. In one out of 50 cases there was observed a reduction in the left vertebral artery and the appearance of the internal carotid artery on the same side. In that case the left part of the arterial circle of the brain was supplied with blood by an internal carotid artery, which was present only in that animal.

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25

Tse, Gary G., Elna M. Masuda, Aaron M. McMurtray, and Beau K. Nakamoto. "Coiled Internal Carotid Arteries Associated with Bilateral Sequential Strokes." Case Reports in Vascular Medicine 2013 (2013): 1–4. http://dx.doi.org/10.1155/2013/929530.

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The risk of stroke and management of coiling of the cervical internal carotid artery in the absence of an atherosclerotic carotid bulb lesion is unclear. We report a case of an otherwise healthy 39-year-old woman who developed bilateral sequential strokes associated with bilateral coiled internal carotid arteries. We discuss the risk of stroke and management of coiled carotid arteries as they relate to the patient presented.

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26

HANAKITA, Junya, Hideyuki SUWA, Shogo NISHI, Fumihito OHTA, and Hiroshi SAKAIDA. "Bilateral Aneurysms of Extracranial Internal Carotid Arteries." Neurologia medico-chirurgica 31, no. 13 (1991): 972–77. http://dx.doi.org/10.2176/nmc.31.972.

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27

Tubbs, R. Shane, Andrew J. DeNardo, and Aaron A. Cohen-Gadol. "Intercavernous connection between the internal carotid arteries." Journal of Neurosurgery: Pediatrics 8, no. 6 (December 2011): 625–27. http://dx.doi.org/10.3171/2011.9.peds11225.

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Intercavernous communication between the left and right internal carotid arteries is an uncommon entity. The authors report a case involving a pediatric patient who was found to have such a vascular anomaly. Such variations should be known by the neurosurgeon so as to avoid misdiagnosis and potential iatrogenic injury.

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28

WADE, J. P. H., W. WONG, H. J. M. BARNETT, and P. VANDERVOORT. "BILATERAL OCCLUSION OF THE INTERNAL CAROTID ARTERIES." Brain 110, no. 3 (1987): 667–82. http://dx.doi.org/10.1093/brain/110.3.667.

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29

Rosenthal, David. "Bilateral occlusion of the internal carotid arteries." Journal of Vascular Surgery 8, no. 4 (October 1988): 550. http://dx.doi.org/10.1016/0741-5214(88)90132-2.

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30

Ogawa, T., T. Miyauchi, T. Kato, and Y. Tamakawa. "Internal carotid origin of double ophthalmic arteries." Neuroradiology 32, no. 6 (December 1990): 508–10. http://dx.doi.org/10.1007/bf02426466.

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31

Davies, K. N., and P. R. Humphrey. "Do carotid bruits predict disease of the internal carotid arteries?" Postgraduate Medical Journal 70, no. 824 (June 1, 1994): 433–35. http://dx.doi.org/10.1136/pgmj.70.824.433.

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32

FUKUDA, IKUO, KOTOO MEGURO, SHOHNOSUKE MATSUSITA, OSAMU SHIGETA, NORIYOSHI OOHASHI, and YOSHITAKA NAKTA. "Traumatic Disruption of Bilateral Vertebral Arteries and Internal Carotid Arteries." Journal of Trauma: Injury, Infection, and Critical Care 29, no. 2 (February 1989): 263–66. http://dx.doi.org/10.1097/00005373-198902000-00025.

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33

Rajani, S. "An investigation of virgin variation of branching pattern of ECA and CCA: a case report." Journal of Morphological Sciences 34, no. 01 (January 2017): 010–12. http://dx.doi.org/10.4322/jms.096715.

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Abstract Introduction: Common carotid and its two major branches, external and internal carotid arteries form arterial network for blood supply in the head and neck region. Variations in configuration and branching pattern of these arteries change the irrigation pattern and complicate the identification of specific arteries during surgical intervention coupled with imagery interpretation for diagnosis. Though handful variations have been documented yet there is strong need to report unusual, new and virgin organization of configuration and branching pattern in these arteries. Case Report: During dissection of head and neck region, anomalous branching pattern consisting of bilateral trifitrcation/quadrification of common and external carotid arteries and abnormal trifitrcation of distal external carotid artery was observed. Conclusion: Lack of knowledge of these variants in branching coniguration may lead to unfortunate differential diagnosis and iatrogenic complications.

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Pearce, W. J., S. Ashwal, D. M. Long, and J. Cuevas. "Hypoxia inhibits calcium influx in rabbit basilar and carotid arteries." American Journal of Physiology-Heart and Circulatory Physiology 262, no. 1 (January 1, 1992): H106—H113. http://dx.doi.org/10.1152/ajpheart.1992.262.1.h106.

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We examined the hypothesis that hypoxia inhibits Ca2+ influx in isolated rabbit common carotid, internal carotid, and basilar arteries. In arteries mounted for measurement of isometric tension and exposed to 122 mM K+ in Ca(2+)-free Krebs, cumulative addition of Ca2+ produced Ca(2+)-force relations that were right-shifted by hypoxia (PO2 approximately 15 Torr) with no decrease in maximum force attained. In arteries precontracted with 122 mM K+, exposure to hypoxia produced relaxations whose rates and magnitudes were enhanced by reductions in bath Ca2+ from 8.0 to 0.8 mM. Using an ethylene glycol-bis(beta-aminoethyl ether)-N,N,N',N'-tetraacetic acid method for 3-min 45Ca influx measurements, modified for use in rabbit basilar and carotid arteries, we found that resting levels of Ca2+ influx (mumol.min-1.kg dry wt-1) were significantly higher in basilar (67 +/- 1, n = 10) than in internal carotid (27 +/- 1, n = 12) or common carotid (33 +/- 1, n = 12) arteries. K+ stimulation increased Ca2+ influx more than two-fold compared with control in all three artery types, and hypoxia inhibited this increase by 74% in basilar, 49% in internal carotid, and 33% in common carotid arteries. Exposure to 10 microM serotonin and 100 microM uridine 5'-triphosphate (UTP) also increased Ca2+ influx, but these increases were less than observed during K+ contractions and averaged 10 (basilar), 31 (internal carotid), and 82% (common carotid) above control. Hypoxia completely inhibited serotonin- and/or UTP-induced increases in Ca2+ influx in basilar and internal carotid segments and inhibited 47% of this increase in the common carotid segments.(ABSTRACT TRUNCATED AT 250 WORDS)

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Negrotto, Matías, Roberto Crosa, Alejandra Jaume, and Fiorella Casanova. "Transarterial Embolization of an Indirect Carotid- Cavernous Fistula with N-Butyl Cyanoacrylate." JBNC - JORNAL BRASILEIRO DE NEUROCIRURGIA 25, no. 2 (March 26, 2018): 150–56. http://dx.doi.org/10.22290/jbnc.v25i2.1109.

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Carotid-cavernous fistulas are vascular shunts that allow blood to flow from the carotid artery into the cavernous sinus. Some fistulas are characterized by a direct connection between the cavernous segment of the internal carotid artery and the cavernous sinus. Other carotid-cavernous fistulas are dural, consisting of a communication between the cavernous sinus and one or more meningeal branches of the internal carotid artery, the external carotid artery, or both. Endovascular management is the treatment modality of choice in these cases. We report the use of N-butyl cyanoacrylate in a successful transarterial embolization of a dural carotid-cavernous fistula fed by arterial branches of the internal -and mainly- external carotid arteries (Barrow type D).

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Aboul Hosn, Maen, Amy Messner, and William J. Sharp. "Congenital Absence of the Common Carotid Artery With Common Origin of the Internal and External Carotid Arteries." Journal for Vascular Ultrasound 42, no. 2 (June 2018): 78–81. http://dx.doi.org/10.1177/1544316718779438.

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Congenital absence of the common carotid artery is a rare vascular anomaly that is usually discovered incidentally in otherwise asymptomatic patients and can potentially pose significant diagnostic and therapeutic challenges. Although it has been typically associated with separate origins of the internal and external carotid arteries, a common origin of both arteries is exceedingly rare and has been reported in 6 cases to date. We present the case of a 70-year-old female, who was referred for a carotid ultrasound after a carotid bruit was auscultated. Carotid duplex scan identified the congenital absence of the right common carotid artery with no significant internal carotid stenosis. This was confirmed by a computed tomography angiography scan of the neck, which showed the right internal and external carotid arteries sharing a common origin off the distal brachiocephalic artery.

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Langille, B. L., M. P. Bendeck, and F. W. Keeley. "Adaptations of carotid arteries of young and mature rabbits to reduced carotid blood flow." American Journal of Physiology-Heart and Circulatory Physiology 256, no. 4 (April 1, 1989): H931—H939. http://dx.doi.org/10.1152/ajpheart.1989.256.4.h931.

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Adaptive responses of rabbit common carotid arteries were examined after 70-80% reductions in blood flow produced by ipsilateral external carotid artery ligation. These flow reductions elicited growth inhibition of arterial wall tissue in immature rabbits. Specifically, experimental carotid arteries exhibited DNA levels significantly lower, by 35%, than contralateral control arteries 1 mo after external carotid ligation. Lower elastin contents (38%) were also observed, although collagen contents were not affected. These changes were accompanied by a relative reduction in wall mass of 30% and a 31% reduction in internal diameter. Adult rabbits exhibited decreased internal diameter (21%) after flow reduction, but no significant change in vessel mass or wall constituents was observed. Early diameter reductions were vasoconstrictor in origin, but the vessel functioned as a smaller artery rather than as a partially constricted normal vessel after 1 mo, i.e., both maximally dilated and maximally constricted diameters were reduced. A reduction in endothelial cell number was detected for the narrowed vessels. Manipulation of local flow conditions indicated that the vessels responded to changes in mean blood flow rather than the pulsatile component of flow.

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Hamed, Sherifa A. "Parasellar meningioma presenting by stroke and bilateral occlusion of the internal carotid arteries: A case report." SAGE Open Medical Case Reports 8 (January 2020): 2050313X2090233. http://dx.doi.org/10.1177/2050313x20902337.

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Cerebrovascular stroke caused by skull base meningioma has been rarely reported. A 30-year-old male presented (April 2015) with acute right-sided hemiplegia. His brain neuroimaging (computerized tomography and magnetic resonance imaging) showed left ischemic infarction in the territory of middle cerebral artery. Magnetic resonance imaging also showed a right parasellar solid lesion which extended to the right basisphenoid and cavernous sinus and attenuated the right internal carotid artery. It also had left smaller parasellar extension. The lesion enhanced uniformly and strongly following gadolinium injection. Digital subtraction angiography using selective catheterization of both common carotid and left vertebral arteries (07/13/2015) showed occlusion of both internal carotid arteries and faint visualization of left terminal internal carotid artery and its bifurcation. The right internal carotid artery and its branches were not visualized. Left vertebral injection showed prominent left vertebral and basilar arteries and filling of both internal carotid arteries through posterior communicating arteries. A faint blush of contrast was noticed at the parasellar region coinciding with meningioma. The patient received three treatment sessions of gamma knife radiosurgery as follow: 20 cc of the tumor was treated with 12 Gy (15 August 2015), 1.7 cc was treated with 10 Gy (31 January 2016), and 2.5 cc was treated with 11 Gy (13 August 2016) which resulted in complete clinical recovery and tumor size reduction. Compensation from the posterior communicating and external carotid arteries might explain the complete clinical recovery after tumor size reduction with gamma knife radiosurgery.

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Amin, Faisal Mohammad, Mohammad Sohail Asghar, Julie W. Ravneberg, Patrick JH de Koning, Henrik BW Larsson, Jes Olesen, and Messoud Ashina. "The effect of sumatriptan on cephalic arteries: A 3T MR-angiography study in healthy volunteers." Cephalalgia 33, no. 12 (April 15, 2013): 1009–16. http://dx.doi.org/10.1177/0333102413483374.

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Aim To explore a possible differential effect of sumatriptan on extracerebral versus cerebral arteries, we examined the superficial temporal (STA), middle meningeal (MMA), extracranial internal carotid (ICAextra), intracranial internal carotid (ICAintra), middle cerebral (MCA) and basilar arteries (BA). Methods The arterial circumferences were recorded blindly using high-resolution magnetic resonance angiography before and after subcutaneous sumatriptan injection (6 mg) in 18 healthy volunteers. Results We found significant constrictions of MMA (16.5%), STA (16.4%) and ICAextra (15.2%) ( p ≤ 0.001). Smaller, but statistically significant, constrictions were seen in MCA (5.5%) and BA (2.1%) ( p ≤ 0.012). ICAintra change 1.8% was not significant ( p = 0.179). The constriction of cerebral arteries was significantly smaller than the constriction of extracerebral arteries ( p < 0.000001). Conclusion Sumatriptan constricts extracerebral arteries more than cerebral arteries. We suggest that sumatriptan may exert its anti-migraine action outside of the blood–brain barrier.

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Oz, Ibrahim Ilker, Ismail Serifoglu, Omer Yazgan, and Zuhal Erdem. "Congenital absence of internal carotid artery with intercavernous anastomosis: Case report and systematic review of the literature." Interventional Neuroradiology 22, no. 4 (April 18, 2016): 473–80. http://dx.doi.org/10.1177/1591019916641317.

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The absence of an internal carotid artery is a rare congenital anomaly. In the absence of the internal carotid artery, collateral circulations develop through the circle of Willis, persistent embryonic arteries or transcranial collaterals of the external carotid artery. Six pathways of collateral circulation have been described. Intercavernous anastomosis is between cavernous segments of the bilateral internal carotid arteries and is rarely seen. Patients with an absence of the internal carotid artery can be completely asymptomatic. However, these patients can present with subarachnoid hemorrhage or stroke accompanying cerebral aneurysm or abnormal collateral. We combined our case with 33 previous publications to form a retrospective series including 35 cases of unilateral internal carotid artery agenesis with intercavernous anastomosis.

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Komiyama, M. "Moyamoya Disease is a Progressive Occlusive Arteriopathy of the Primitive Internal Carotid Artery." Interventional Neuroradiology 9, no. 1 (March 2003): 39–45. http://dx.doi.org/10.1177/159101990300900105.

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The purpose of this literature review is to disclose the relationship between the temporal profile of steno-occlusive changes in the cerebral arteries in moyamoya disease and the embryological evolution of the cerebral arteries. Steno-occlusive changes and progression occur in the sequence of embryological evolution of the primitive internal carotid artery in the early embryological stage. In other words, steno-occlusive changes in the cerebral arteries occur primarily near the bifurcation of the cranial and caudal divisions of the primitive internal carotid artery, evolve from the cranial division to the caudal one, and progress from the bifurcation centrifugally. Steno-occlusive changes do not occur essentially in the distal cortical branches of the primitive internal carotid artery, in any arteries in the external carotid system, which are derived from ventral pharyngeal system and primitive stapedial system, or in any cerebral arteries in the vertebrobasilar system, which are derived from the longitudinal neural arteries. These facts suggest that moyamoya disease is strongly related to the vasculogenesis of the primitive internal carotid artery and genetic factors play a major role in the clinical manifestations of moyamoya disease.

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Campos-Herrera, Cynthia Resende, Milberto Scaff, Fábio Iuji Yamamoto, and Adriana Bastos Conforto. "Spontaneous cervical artery dissection: an update on clinical and diagnostic aspects." Arquivos de Neuro-Psiquiatria 66, no. 4 (December 2008): 922–27. http://dx.doi.org/10.1590/s0004-282x2008000600036.

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Spontaneous cervical arterial dissection (SCAD) is a non-traumatic tear or disruption in the wall of the internal carotid arteries or the vertebral arteries. It accounts for about 25% of strokes in patients aged under 45 years. Awareness of its clinical features and advances in imaging over the last two decades have contributed to earlier identification of this condition. SCAD has become the commonest form of vascular lesion identified in the cervical carotid and vertebral arteries, second only to atherosclerosis. This review is an update on the epidemiology, vulnerable arterial segments, risk factors, clinical features, diagnosis, current treatment and prognosis of SCAD.

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Osawa, Shigeyuki, Albert L. Rhoton, Necmettin Tanriover, Satoru Shimizu, and Kiyotaka Fujii. "Microsurgical Anatomy and Surgical Exposure of the Petrous Segment of the Internal Carotid Artery." Operative Neurosurgery 63, suppl_4 (October 1, 2008): ONS210—ONS239. http://dx.doi.org/10.1227/01.neu.0000327037.75571.10.

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Abstract Objective: The petrous segment of the internal carotid artery has been exposed in the transpetrosal, subtemporal, infratemporal, transnasal, transmaxillary, transfacial, and a variety of transcranial approaches. The objective of the current study was to examine anatomic features of the petrous carotid and its branches as related to the variety of approaches currently being used for its exposure. Methods: Twenty middle fossae from adult cadaveric specimens were examined using magnification of ×3 to ×40 after injection of the arteries and veins with colored silicone. Results: The petrous carotid extends from the entrance into the carotid canal of the petrous part of the temporal bone to its termination at the level of the petrolingual ligament laterally and the lateral wall of the sphenoid sinus medially. The petrous carotid from caudal to rostral was divided into 5 segments: posterior vertical, posterior genu, horizontal, anterior genu, and anterior vertical. Fourteen (70%) of the 20 petrous carotids had branches. The branch that arose from the petrous carotid was either a vidian or periosteal artery or a common trunk that gave rise to both a vidian and 1 or more periosteal arteries. The most frequent branch was a periosteal artery. Conclusion: An understanding of the complex relationships of the petrous carotid provides the basis for surgically accessing any 1 or more of its 5 segments.

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Chowdhury, Jamil Haider, and Krishna Kishore Saha. "Measurement of Peak Systolic Velocities and End Diastolic Velocities of Common Carotid, Internal Carotid and Vertebral Arteries of Healthy Adult Subjects by Duplex Colour Doppler Sonography : A Study of 100 Cases." IAHS Medical Journal 4, no. 1 (April 12, 2022): 17–21. http://dx.doi.org/10.3329/iahsmj.v4i1.59103.

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Background : Duplex Colour Doppler Sonography is a well-accepted non invasive means for diagnosis and evaluation of carotid and vertebral artery disease. As these arteries are the main supply of brain, determination of their percentage of stenosis accurately is very much important. The accuracy of measurement of percent stenosis using doppler technique depends significantly on measured blood flow velocities in these arteries. As a result, a normal reference value of peak systolic velocity and end diastolic velocity for these arteries are needed upon which the calculation of percentage stenosis depends. At this context, this study was done with the following objectives: To measure Peak Systolic Velocities and End Diastolic Velocities of common carotid, internal carotid and vertebral arteries of healthy adult subjects by duplex colour doppler sonography, to estimate the velocity difference in extra - cranial neck vessels of right and left side and to observe the velocity difference between males and females. Materials and methods : This cross-sectional study was conducted among Bangladeshi healthy adult subjects in the Department of Radiology and Imaging, Bangabandhu Sheikh Mujib Medical University (BSMMU) from January2009 to December 2009. 100 Bangladeshi healthy adult subjects were selected which included 50 males and 50 females. All the subjects underwent duplex colour doppler scanning of their Common Carotid Artery (CCA) Internal Carotid Artery (ICA) and Vertebral Arteries (VA) on both sides. Peak Systolic Velocities (PSV) and End-Diastolic Velocities (EDV) of the above arteries on both sides were recorded for analysis. Results: In case of male subjects, mean PSV of common carotid, internal carotid and vertebral arteries on the right side are 66, 57 and 30 cm/sec and on the left side are 72, 58 and 32 cm/sec consecutively. In the case of male subjects, mean EDV of common carotid, internal carotid and vertebral arteries on the right side are 19, 16 and 10 cm/sec and on the left side are 21, 21 and 15 cm/sec consecutively. In case of female subjects, mean PSV of common carotid, internal carotid and vertebral arteries on the right side are 62, 57 and 29 cm/sec and on the left side are 65, 57 and 30 cm/sec consecutively. In the case of female subjects, mean EDV of common carotid, internal carotid and vertebral arteries on the right side are 20, 19 and 14 cm/sec and on the left side are 21,17 and 14 cm/sec consecutively. Conclusion: From this study, we have provided reference values of peak systolic velocity and end diastolic velocity for these arteries (CCA, ICA & VA) in Bangladeshi population. IAHS Medical Journal Vol 4(2), June 2021; 17-21

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Upadhyaya, Prabhaw, Prasanna Karki, Baburam Pokharel, and Gopal Raman Sharma. "Bilateral Internal Carotid Arteries Occlusion: A Case Report." Journal of Nepal Medical Association 60, no. 246 (February 15, 2022): 207–10. http://dx.doi.org/10.31729/jnma.6877.

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Bilateral internal carotid artery occlusion is a disease that is encountered rarely. We report a case of a 54 years old female smoker, who presented with acute onset right-sided limb weakness, facial deviation and slurring of speech. On computed tomography angiography occlusion of the bilateral internal carotid artery was seen and a high-flow collateral circulation was formed through the vertebrobasilar system. Computed tomography brain perfusion showed marked cerebral hypoperfusion on the left side. The patient was thrombolysed and kept on dual antiplatelet therapy. Post-medical treatment, motor power and speech significantly improved.

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Souza, Fernanda de, and Rui Campos. "A systematic study of the brain base arteries in the rabbit (Oryctolagus cuniculus)." Pesquisa Veterinária Brasileira 33, no. 6 (June 2013): 796–806. http://dx.doi.org/10.1590/s0100-736x2013000600018.

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The brains of 30 New Zealand rabbits (Oryctolagus cuniculus) were injected with red stained latex. The arteries of the ventral surface of the brain were systematized on the right (R) and on the left (L) side with the respective percentage of appearance: the aortic arch emitted the braquicephalic trunk and the left subclavian artery (83.3%); or the braquicephalic trunk, the left common carotid artery and the left subclavian artery (16.7%). The braquicephalic trunk emitted the right and the left common carotid arteries and the right subclavian artery (83.3%); or the right common carotid artery and the right subclavian artery (16.7%). The common carotid arteries were divided into external and internal carotid arteries (96.7% on the R, 100% on the L.). The internal carotid artery to the R was present (96.7%) and absent (3.3%), and to the L, was present (100%). The rostral choroidal artery to the R was collateral branch of the rostral branch of the internal carotid artery (83.3%), collateral branch of caudal branch of the internal carotid artery (16.7%), and to the L was collateral branch of the rostral branch of the internal carotid artery (93.3%), collateral branch of the caudal branch of the internal carotid artery (6.7%). The middle cerebral artery to the R and to the L was single (80%) and double (20%). The rostral cerebral artery to the R had middle caliber (90%), thin caliber (6.7%) and too thin caliber (3.3%), and to the L had middle caliber (76.7%), thin caliber (16.7%) and too thin caliber (6.7%). The internal ethmoidal artery was absent (73.3%), present and single (26.7%). The caudal cerebral artery to the R was single (66.7%), double (26.7%) and triple (6.7%), and to the L was single (63.3%) and double (36.7%). The terminal branches of the right and left vertebral arteries were present (100%, and formed the basilar artery (100%). The ventral spinal artery was present (100%). The caudal cerebellar artery, to the R was single (43.3%), single with labyrinthic artery isolated (26.7%) and double (30%), and to the L was single (50%), single with labyrinthic artery isolated (6.7%), double (40%) and triple (3.3%). The trigeminal artery to the R and to the L was present (100%). The rostral cerebellar artery to the R was single (53.3%) and double (46,7%), and to the L was single (63.3%) and double (36.7%). The rabbit's cerebral arterial circle was caudally closed (100%) and rostrally closed (93.3%) or opened (6.7%). The brain was supplied by the vertebral-basilar and carotid systems.

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Hamilton, Russell D., Cory E. Shield, and David Laughrun. "Progression of asymptomatic mild carotid artery stenosis: Implications for frequency of surveillance." Vascular Medicine 22, no. 5 (August 19, 2017): 411–17. http://dx.doi.org/10.1177/1358863x17722215.

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We looked retrospectively at the 3- to 5-year progression of mild, asymptomatic carotid artery stenosis (CAS). A random sample of 600 patients who had undergone at least two carotid artery duplex ultrasounds between 31 October 2006 and 1 November 2016 with a second duplex ⩾3 and ⩽5 years following the initial one were screened for inclusion. Internal carotid arteries (ICAs) were included if they had 20–49% stenosis on the initial duplex, with 440 carotid arteries meeting this criteria. Analyses were performed utilizing chi-squared and two-tailed t-tests. Twenty-four (5.45%) of the initial 440 carotid arteries progressed to moderate CAS. There was a statistically significant increase in the prevalence of hypertension (68% vs 47%, p=0.022) and diabetes mellitus (44% vs 22%, p=0.008) in patients with carotids that progressed to moderate CAS. There was a decrease in moderate-intensity statin use (32% vs 58%, p=0.005) and an increase in patients not on statins (36% vs 11%, p=0.001) in the group of carotids that progressed to moderate CAS. One carotid artery (0.2%) progressed from mild CAS to severe CAS. If supported by others, our data may lead to a change in the recommendations regarding appropriate follow-up of asymptomatic CAS.

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Nakayama, T., K. Tanaka, and M. Kaneko. "Angioplasty of Acute Occluded Cerebral Arteries." Interventional Neuroradiology 3, no. 2_suppl (November 1997): 51–52. http://dx.doi.org/10.1177/15910199970030s208.

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22 cases of stenosed or occluded cerebral arteries were treated by percutaneous transluminal angioplasty (PTA) in acute stage. There were 10 internal carotid lesions, 4 middle cerebral artery lesions, 5 intracranial vertebral artery lesions, and 3 basilar artery lesions. 14 cases were treated for residual stenosis after recanalization using urokinase. Successful dilatation (over 50%) was achieved in 16 cases (73%). 3 lesions were inaccessible due to atherosclerotic change. There were no major complications. Restenosis was observed in 4 internal carotid lesions and 1 middle cerebral lesion. 7 (50%) cases with internal carotid lesions and 5 (63%) cases with vertebrobasilar lesions returned to their previous life. The results suggest that PTA in acute stage is feasible for occlusive disease of cerebral arteries.

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Bushman, Jordan, Nazanene Esfandiari, Jayapalli Bapuraj, and David Shlensky. "RF25 | PMON76 Kissing carotid arteries: An unusual cause of male hypogonadotropic hypogonadism." Journal of the Endocrine Society 6, Supplement_1 (November 1, 2022): A586. http://dx.doi.org/10.1210/jendso/bvac150.1214.

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Abstract Background Aneurysms of the internal carotid arteries are a rare cause of pituitary dysfunction1. While there are reports of primary amenorrhea in females due to ectatic internal carotid arteries2, hypogonadism in a male due to "kissing internal carotid arteries" causing compression of the pituitary gland has not previously been reported. Clinical Case A 27-year-old male with history of Crohn's disease, obesity, depression and sleep apnea on CPAP presented to endocrinology clinic for evaluation of low testosterone levels diagnosed 9 months prior to his initial visit. At the time of initial evaluation patient was using intramuscular testosterone cypionate 120mg weekly with total testosterone of 2.43 ng/mL (2.50-9.50 ng/mL). Testosterone replacement therapy was discontinued at that time to assess the hypothalamic-pituitary-gonadal (HPG) axis. After 9 months without testosterone treatment, repeat labs demonstrated total testosterone 0.91 ng/mL, bioavailable testosterone 0.69 ng/mL (1.10-4.0 ng/mL), SHBG 8 nmol/L (10-89 nmol/L), LH 3.1 mIU/mL (2-12 mIU/mL), FSH 2.7 mIU/mL (1.5-10 mIU/mL), estradiol 23 pg/mL (6-44 pg/mL), IGF-1 193 ng/mL (85-310 ng/mL), prolactin 10 ng/mL (3-23 ng/mL), TSH 1.03 mIU/L (0.3-5.5 mIU/L), FT4 1.15 ng/dL (0.76-1.70 ng/dL), 8 AM cortisol 13.5 ug/dL (5.3-22.5 ug/dL) and ACTH 37 pg/mL (5-52 pg/mL). Semen analysis was also performed which was unremarkable. Pituitary MRI revealed symmetric ectatic cavernous portions of the internal carotid arteries compressing and distorting the normal anatomy of the anterior pituitary gland consistent with "kissing carotid arteries." MRA was performed which did not demonstrate aneurysm or malformation of the cavernous internal carotid arteries. Patient was started on subcutaneous semaglutide 0.25mg weekly which was titrated to 1mg weekly for treatment of obesity. Testosterone replacement therapy was not re-initiated given future fertility goals and normal semen analysis. Conclusion To our knowledge, this is the first reported case of kissing internal carotid arteries causing isolated hypogonadotropic hypogonadism in a male patient. References 1) Heshmati HM, Fatourechi V, Dagam SA, Piepgras DG. Hypopituitarism caused by intrasellar aneurysms. Mayo Clin Proc. 2001 Aug;76(8): 789-93. doi: 10.1016/S0025-6196(11)63222-9. PMID: 11499817 2) Sahin M, Dilli A, Karbek B, Unsal IO, Gungunes A, Colak N, Uçan B, Cakal E, Ozbek M, Delibasi T. Unusual cause of primary amenorrhea due to kissing internal carotid arteries. Pituitary. 2012 Jun;15(2): 258-9. doi: 10.1007/s11102-012-0393-9. PMID: 22492265. Presentation: Monday, June 13, 2022 12:30 p.m. - 2:30 p.m., Monday, June 13, 2022 12:44 p.m. - 12:49 p.m.

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Cho, Dong Young, Bum-soo Kim, Jinhee Jang, Hyun Seok Choi, So Lyung Jung, Kook-jin Ahn, and Yong Sam Shin. "Cerebellar artery arising from the cavernous segment of the internal carotid artery and persistent trigeminal artery: a spectrum of incomplete longitudinal fusion." Acta Radiologica 61, no. 3 (July 25, 2019): 386–94. http://dx.doi.org/10.1177/0284185119861310.

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Background The embryological relationship between cerebellar arteries originating directly from the cavernous segment of the internal carotid artery and persistent trigeminal artery is not well understood. Purpose To evaluate the incidence and pattern of cerebellar arteries originating from the internal carotid artery and persistent trigeminal artery, and to discuss their probable embryological relationship. Material and Methods We reviewed 5113 angiographic studies from 5093 patients at our institution over the last eight years, searching for patients with persistent trigeminal artery and cerebellar arteries originating from a cavernous segment of internal carotid artery (persistent trigeminal artery variant). Results Of the 5093 patients, 27 patients had persistent trigeminal artery or persistent trigeminal artery variant (0.53%). Twenty patients (6 men, 14 women; median age = 54 years) had persistent trigeminal artery (0.39%). Seven patients (2 men, 5 women, age range = 37–72 years; median age = 57 years) had a persistent trigeminal artery variant with persistent trigeminal artery terminating in a cerebellar artery without direct connection to the basilar artery (persistent trigeminal artery variant; 0.14%). The terminal branch of the persistent trigeminal artery variant was an anterior inferior carotid artery in five patients and a superior cerebellar artery in two patients. Of the seven patients having persistent trigeminal artery variant, four patients had another artery from the basilar artery to the anterior inferior carotid artery territory. In 6/20 patients with persistent trigeminal artery, there was an anterior inferior carotid artery arising from the persistent trigeminal artery. One of these patients showed another arterial branch from the basilar artery to the anterior inferior carotid artery territory. Conclusion Persistent trigeminal artery variant and cerebellar arteries originating from the persistent trigeminal artery are both believed to be a spectrum of incomplete fusion of the longitudinal neural arteries. Understanding the precise anatomy is important in diagnostic and therapeutic settings for related vascular disease.

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