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Ando M, Maki Y, Ishibashi R. Developed Collateral Networks between the Internal Carotid Artery and External Carotid Artery: Carotid Rete Mirabile. JOURNAL OF NEUROENDOVASCULAR THERAPY 2023; 17:93-95. [PMID: 37502351 PMCID: PMC10370507 DOI: 10.5797/jnet.ai.2022-0063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 01/08/2023] [Indexed: 07/29/2023]
Affiliation(s)
- Mitsushige Ando
- Department of Neurosurgery, Shiga General Hospital, Moriyama, Shiga, Japan
| | - Yoshinori Maki
- Department of Rehabilitation, Hikari Hospital, Otsu, Shiga, Japan
- Department of Neurosurgery, Hikone Chuo Hospital, Hikone, Shiga, Japan
| | - Ryota Ishibashi
- Department of Neurosurgery, Kitano Hospital, Tazuke Kofukai Medical Research Institute, Osaka, Osaka, Japan
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Whitley H, Zazay A, Skalický P, Malík J, Charvát F, Beneš V, Bradáč O. Congenital internal carotid artery hypoplasia: A systematic review. Neuroradiol J 2023; 36:5-16. [PMID: 35713190 PMCID: PMC9893166 DOI: 10.1177/19714009221108668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
This review evaluates the current evidence for the clinical management of congenital internal carotid artery hypoplasia (CICAH). We summarise clinical presentations diagnostic standards, imaging recommendations, treatment and follow-up. The review was prompted by a case of CICAH in a 50-year-old female who presented to our neurosurgery clinic with an acute episode of vertigo. The patient underwent CT angiogram, which showed an unusually low right carotid bifurcation. The right internal carotid artery (ICA) was hypoplastic, and the A1 segment of the anterior cerebral artery (ACA) was absent. Skull base CT showed an ipsilateral hypoplastic carotid canal. To summarise current evidence for clinical management of CICAH we followed PRISMA guidelines to identify papers meeting our predefined inclusion criteria. We searched three databases using the terms 'ICA' and 'Hypoplasia'. We reviewed 41 papers meeting our criteria. 34 were clinical reports. We performed a data extraction and quality appraisal on these reports. We found that CICAH may be less rare than previously described. Blood pressure control in CICAH is crucial due to the increased risk of stroke and aneurysm formation. Follow-up imaging is strongly recommended. Carotid doppler sonography is a powerful and underutilised diagnostic tool, and carotid canal hypoplasia is not a pathognomic sign. In conclusion, clinicians should be alert to anatomic variations such as CICAH because these produce haemodynamic changes that may have serious clinical consequences. We recommend a central registry of patients with CICAH in order to understand the longer-term natural history of the condition.
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Affiliation(s)
- Helen Whitley
- Department of Neurosurgery and
Neurooncology, First Medical Faculty, Charles University and Military University
Hospital, Praha, Czechia
| | - Awista Zazay
- Department of Neurosurgery and
Neurooncology, First Medical Faculty, Charles University and Military University
Hospital, Praha, Czechia
| | - Petr Skalický
- Department of Neurosurgery and
Neurooncology, First Medical Faculty, Charles University and Military University
Hospital, Praha, Czechia
| | | | - František Charvát
- Department of Radiology, Military University Hospital, Praha, Czechia
| | - Vladimír Beneš
- Department of Neurosurgery and
Neurooncology, First Medical Faculty, Charles University and Military University
Hospital, Praha, Czechia
| | - Ondřej Bradáč
- Department of Neurosurgery and
Neurooncology, First Medical Faculty, Charles University and Military University
Hospital, Praha, Czechia
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Xu X, Shen H, Ma H, Zhang X, Zhang L, Li Q, Zhao R, Dai D, Li Z, Yang P, Liu J. Cerebrovascular disorders associated with agenesis of the internal carotid artery: Findings on digital subtraction angiography. Front Surg 2022; 9:953697. [PMID: 36420405 PMCID: PMC9676253 DOI: 10.3389/fsurg.2022.953697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 10/11/2022] [Indexed: 11/09/2022] Open
Abstract
Objective Agenesis of the internal carotid artery (ICA) is a rare vascular condition that is complicated by intracranial aneurysms and rete mirabile. The altered hemodynamics caused by this distinctive cerebrovascular angioarchitecture can cause ischemic or hemorrhagic accidents. Data on clinical and radiographic features have been limited to describing this vascular pattern. We present five cases of agenesis of the internal carotid artery confirmed by digital subtraction angiography (DSA) and further investigate the influence of altered angioarchitecture on the integrity of intracranial morphology. Methods Cases of ICA anomalies were screened from the patients who underwent DSA in two hospitals. Clinical manifestation, radiographic features, management, and outcomes were retrospectively reviewed. Results Five patients [mean age 44 years (range, 30–65 years)] were included. Two patients presented with subarachnoid hemorrhage, one with cognitive impairment, one with dizziness, and one with intermittent headache. DSA demonstrated that three cases were complicated by intracranial aneurysms, one by dural arteriovenous fistula, and one by rete aneurysm. Three patients underwent endovascular treatment and one underwent bypass surgery. No patient died or experienced cerebrovascular accident during short-term follow-up. Conclusions ICA agenesis can be complicated by disorders such as intracranial aneurysm, rete aneurysm, and dural arteriovenous fistula. This suggests that ICA agenesis is associated with a tendency towards disrupted cerebrovascular homeostasis resulting from altered hemodynamics.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Zifu Li
- Correspondence: Zifu Li Pengfei Yang
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Matsoukas S, Fifi JT, Shigematsu T. Lethal subarachnoid haemorrhage in a patient with rete mirabile network of the posterior circulation with associated aneurysm. BMJ Case Rep 2022; 15:e245010. [PMID: 35217549 PMCID: PMC8883206 DOI: 10.1136/bcr-2021-245010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/28/2021] [Indexed: 11/04/2022] Open
Abstract
Rete mirabile (RM), an arterial network normally existing in some vertebrate animals interconnecting the extracranial and intracranial arterial circulation, can rarely be found in humans whether asymptomatic or presenting with cerebral ischaemia or haemorrhage. Encompassing diverse angiographic characteristics and similarities with other arterial malformations, proper diagnosis and differential diagnosis is challenging. We hereby describe an unusual RM case variant, presenting to us with lethal subarachnoid haemorrhage owing to a ruptured small aneurysm associated with the RM network. Angiography disclosed an absent P1 segment of the posterior cerebral artery (PCA) and an RM network anastomosing the basilar apex with the normal distal PCA. Brain death was confirmed on the fifth day after admission and attributed to the severity of subarachnoid haemorrhage (SAH). This is an exceedingly rare case representing an intradural-to-intradural RM anastomosis in a patient presenting with lethal SAH. RM epidemiology, pathophysiology, presentation, angiographic findings and prognosis are reviewed.
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Affiliation(s)
- Stavros Matsoukas
- Department of Neurosurgery, Mount Sinai Hospital, New York, New York, USA
| | - Johanna T Fifi
- Department of Neurosurgery, Mount Sinai Hospital, New York, New York, USA
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Imaging Classification of Internal Carotid Artery Hypoplasia Based on Distal Ophthalmic Segment Occlusion. J Stroke Cerebrovasc Dis 2019; 28:104304. [PMID: 31399279 DOI: 10.1016/j.jstrokecerebrovasdis.2019.104304] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 07/07/2019] [Accepted: 07/21/2019] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Internal carotid artery (ICA) hypoplasia (ICAH) is rare. The classification of ICAH is largely unclear. The aim of the study is to propose a new imaging classification for ICAH based on the occlusion of the distal ophthalmic segment and discuss the clinical and radiological differences between the different types. MATERIALS AND METHODS This was a retrospective study of patients with congenital ICAH diagnosed at the Department of Neurology of the China-Japan Friendship Hospital between June 2011 and June 2016. The patients underwent temporal bone computed tomography (CT), brain CT, cranial magnetic resonance imaging, transcranial Doppler, and head and neck CT angiography. RESULTS A total of 20 ICAH patients were divided into the distal occlusion (12 cases; 60%) and nondistal occlusion (8 cases; 40%) types based on whether the distal ophthalmic segment was occluded. The frequencies of collateral circulation from the circle of Willis (P = .01) and dilated cerebrovascular lesions (P = .001) in the distal occlusion type was higher than in the nondistal occlusion type. Five (25%) patients developed adverse cerebrovascular events during followup: 3 ischemic cases were of the nondistal occlusion type, and 2 cases with subarachnoid hemorrhage were of the distal occlusion type. CONCLUSIONS A novel classification of ICAH was revealed based on the occlusion of the distal ophthalmic segment. The 2 types may show differences in collateral circulation patterns, coexisting cerebrovascular abnormalities, and potential clinical outcomes.
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Paschoal EHA, Yamaki VN, Júnior FMP, Piske RL, Teixeira MJ, Bor-Seng-Shu E. Carotid rete mirabile associated with subarachnoid hemorrhage from intracranial aneurysm: A case report and systematic review. Interv Neuroradiol 2015; 21:55-60. [PMID: 25934776 PMCID: PMC4757198 DOI: 10.15274/inr-2014-10107] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Carotid rete mirabile (CRM) is a rare physiological vascular network in humans that is most often found in Eastern populations. This paper describes a CRM associated with an aneurysmal subarachnoid hemorrhage (aSAH) and discusses the details of the patient's treatment. A 28-year-old woman was admitted to our service with clinical signs and symptoms of a spontaneous aSAH. Computed tomography revealed a diffuse and extensive SAH (Fisher group IV), while an angiogram showed an abnormal collateral network in the right carotid system and a hypoplastic aspect to the internal carotid artery (ICA) on the same side. In addition, a saccular aneurysm with a diameter of 9.5 mm was present in the ophthalmic segment of the left ICA. This case is extremely uncommon. To avoid rebleeding in the patient, we successfully treated the patient by clipping the aneurysmal lesion. No procedure was performed for the CRM.
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Affiliation(s)
| | - Vitor Nagai Yamaki
- Division of Neurosurgery, Hospital Ophir Loyola, Federal University of Para, Belem, Brazil
| | | | - Ronie Leo Piske
- Division of Neuroradiology, Hospital Beneficência Portuguesa de São Paulo, São Paulo, Brazil
| | | | - Edson Bor-Seng-Shu
- Division of Neurosurgery, Hospital das Clinicas, University of São Paulo, São Paulo, Brazil
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Paschoal EHA, Yamaki VN, Júnior FMP, Piske RL, Teixeira MJ, Bor-Seng-Shu E. Carotid rete mirabile associated with subarachnoid hemorrhage from intracranial aneurysm: A case report and systematic review. Interv Neuroradiol 2015. [DOI: 10.1177/inr-2014-10107] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Albuquerque Paschoal EH, Yamaki VN, Mendes Paschoal Jr F, Piske RL, Teixeira MJ, Bor-Seng-Shu E. Carotid Rete Mirabile Associated with Subarachnoid Hemorrhage from Intracranial Aneurysm. Interv Neuroradiol 2015. [DOI: 10.15274/inr-2015-10108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Ghosh SK. Johann Vesling (1598-1649): seventeenth century anatomist of Padua and his Syntagma Anatomicum. Clin Anat 2014; 27:1122-7. [PMID: 25125074 DOI: 10.1002/ca.22454] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2014] [Revised: 07/14/2014] [Accepted: 07/22/2014] [Indexed: 11/12/2022]
Abstract
Johann Vesling (1598-1649) was a German anatomist and surgeon who belonged to the golden period of the illustrious University of Padua. He made significant contributions to the advancement of anatomical knowledge during the 17th century and is remembered most for his remarkable anatomical work, the Syntagma Anatomicum, which was published in 1641. He was the first to describe the soleus muscle and to emphasize its resemblance to the sole fish. He produced the earliest illustrations of the human lymphatic system and was one of the first to document observations about the thoracic duct. He was also the first to report the bifurcation of the human hepatic portal vein on entering the fissure of the liver. His observations from embryological experiments were critical for understanding the development of the four-chambered heart. He was one of the first authors to state that four pulmonary veins empty into the left atrium of the heart. Syntagma Anatomicum (1641) was the most widely used anatomical text in Europe for almost a century and was republished a number of times with editions in Latin, German, Dutch, and English. Syntagma was the first illustrated western anatomical text to reach Japan and laid the foundation for the development of European medicine there. The illustrations used in it deviated from the artistic convention that had characterized anatomical figures from the time of Vesalius, and focused instead on representing anatomical details to make them helpful for medicine and surgery. Clin. Anat. 27:1122-1127, 2014. © 2014 Wiley Periodicals, Inc.
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Affiliation(s)
- Sanjib Kumar Ghosh
- Department of Anatomy, ESI-PGIMSR & ESIC Medical College, Joka, Kolkata, West Bengal, India
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Stojanov D, Bosnjakovic P, Ristic S, Benedeto-Stojanov D, Petrovic S. Multichannel fenestration of the petrous and cavernous segments of the internal carotid artery associated with two small carotid canals. Neurol Sci 2012; 34:247-50. [PMID: 22391678 DOI: 10.1007/s10072-012-0995-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2011] [Accepted: 02/20/2012] [Indexed: 11/24/2022]
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