Bilateral Internal Carotid Artery Segmental Agenesis: Embryology, Common Collateral Pathways, Clinical Presentation, and Clinical Importance of a Rare Condition

Alexandre, Andrea; Visconti, Emiliano; Schiarelli, Chiara; Frassanito, Paolo; Pedicelli, Alessandro

doi:10.1016/j.wneu.2016.08.012

Cited by 17 publications

(8 citation statements)

References 38 publications

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“…ICA is formed by extending from the paired dorsal aorta towards the cephalic side on embryonic days 28–30 (4–5.7 mm) ( 3 ). In the embryonic stage of 5–8 mm, pairs of longitudinal nerve arteries appear along the turbid brain and merge to form basilar arteries.…”

Section: Introductionmentioning

confidence: 99%

Is fetal‑type posterior cerebral artery a risk factor for intracranial aneurysm as analyzed by multislice CT angiography?

Wan

2017

Exp Ther Med

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Fetal-type posterior cerebral artery (FTP) is a common anatomic variation that is closely associated with intracranial aneurysm. In the present study, multislice computed tomography angiography (CTA) was performed to assess whether FTP is a risk factor for intracranial aneurysm. CTA data of 364 consecutive cases of patients who were suspected with cerebrovascular disease or intracranial aneurysm of intracranial artery from 2013 to 2016 were reviewed and the incidence rates of FTP, other variations of the circle of Willis, intracranial aneurysm and FTP with intracranial aneurysm were evaluated. The χ2 test was used to assess the influence of FTP and gender on the incidence rates of other variations of the circle of Willis, intracranial aneurysm and internal carotid artery-posterior communicating artery (ICA-PComA) aneurysm. Binary logistic regression analysis was performed to assess the associations of FTP and gender with intracranial aneurysm and ICA-PComA aneurysm. Compared with non-FTP patients, FTP cases exhibited significantly higher rates of other variations of the circle of Willis (χ2=80.173, P<0.001) and ICA-PComA aneurysm (χ2=4.437, P=0.035). Among patients with FTP and bilateral FTP, more female than male patients with intracranial aneurysm were identified. However, among all patients with intracranial aneurysm, no statistically significant differences in the prevalence of FTP (χ2=2.577, P=0.108) and bilateral FTP (χ2=2.199, P=0.159) between males and females were identified. Binary logistic regression analysis revealed that FTP and gender were risk factors for intracranial aneurysm and ICA-PComA aneurysm. A moderate association between FTP and ICA-PComA aneurysm (OR=2.762) were identified, although there was a weak association between FTP and intracranial aneurysm [odds ratio (OR)=1.365]. Furthermore, a strong association was identified between gender and intracranial aneurysm (OR=0.328), and a moderate association existed between gender and ICA-PComA aneurysm (OR=0.357). In conclusion, female gender is an independent risk factor for intracranial aneurysm, and FTP and female gender are independent risk factors for ICA-PComA aneurysm.

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Section: Introductionmentioning

confidence: 99%

Is fetal‑type posterior cerebral artery a risk factor for intracranial aneurysm as analyzed by multislice CT angiography?

Wan

2017

Exp Ther Med

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“…Bilateral absence of arteries is about 10% [ 7 ] and has been identified in 60 cases in the reviewed literature [ 8 ]. The absence may be related to agenesis or aplasia ICA [ 9 – 11 ]; however, agenesis indicates the complete failure of vessel formation and absence of carotid canal into the embryo what was the case of “our patient”. In aplasia, the carotid canal is reduced in size [ 12 ], the precursor is presented as a remnant, like a fibrous band [ 12 , 13 ] and only one part of the artery may exist eg.…”

Section: Discussionmentioning

confidence: 99%

Stroke in sickle cell disease in association with bilateral absence of the internal carotid arteries. Case report

Marković

Milenković²,

Jocić-Jakubi

et al. 2022

BMC Neurol

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Background Congenital absence of the internal carotid artery (ICA) is a highly infrequent congenital incidence and occurs in less than 0.01% of the population; bilateral absence is exceedingly rare, diagnosed below 10% of the unilateral absence of the ICA. Sickle cell disease (SCD) is a serious disorder and carries a high risk of stroke. Case presentation We present a five-year-old child with SCD who experienced an ischemic stroke episode with epileptic seizures. Neuroimaging revealed the agenesis of both ICAs. The frequency, embryology, and collateral pathway of the vascular anomaly as the clinical presentation, of this rare hematologic disease, are discussed. Conclusions Sickle cell disease (SCD) carries a high risk of stroke. Congenital absence of ICA occurs in less than 0.01% of the population; bilateral absence is diagnosed below 10% of the unilateral absence of the ICA.

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“…One or both of the PCoAs are absent in about 25% of humans (Lippert & Pabst, ). In contrast, absence of the ICAs is very rare, loss of one ICA occurring in less than 0.01%, and two ICAs in less than 0.001%, of the population (Alexandre et al, ).…”

Section: Discussionmentioning

confidence: 99%

Blood flow rate and wall shear stress in seven major cephalic arteries of humans

Seymour

Snelling

2019

Journal of Anatomy

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Blood flow rate (trueQ˙) in relation to arterial lumen radius (ri) is commonly modelled according to theoretical equations and paradigms, including Murray’s Law (trueQ˙ ∝ ri3) and da Vinci’s Rule (trueQ˙ ∝ ri2). Wall shear stress (τ) is independent of ri with Murray’s Law (τ ∝ ri0) and decreases with da Vinci’s Rule (τ ∝ ri-1). These paradigms are tested empirically with a meta‐analysis of the relationships between trueQ˙ and ri in seven major arteries of the human cephalic circulation from 19 imaging studies in which both variables were presented. The analysis shows that trueQ˙ ∝ ri2.16 and τ ∝ ri-1.02, more consistent with da Vinci’s Rule than Murray’s Law. This meta‐analysis provides standard values for trueQ˙, ri and τ in the human cephalic arteries that may be a useful baseline in future investigations. On average, the paired internal carotid arteries supply 75%, and the vertebral arteries supply 25%, of total brain blood flow. The internal carotid arteries contribute blood entirely to the anterior and middle cerebral arteries and also partly to the posterior cerebral arteries via the posterior communicating arteries of the circle of Willis. On average, the internal carotid arteries provide 88% of the blood flow to the cerebrum and the vertebral arteries only 12%.

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Bilateral Internal Carotid Artery Segmental Agenesis: Embryology, Common Collateral Pathways, Clinical Presentation, and Clinical Importance of a Rare Condition

Cited by 17 publications

References 38 publications

Is fetal‑type posterior cerebral artery a risk factor for intracranial aneurysm as analyzed by multislice CT angiography?

Is fetal‑type posterior cerebral artery a risk factor for intracranial aneurysm as analyzed by multislice CT angiography?

Stroke in sickle cell disease in association with bilateral absence of the internal carotid arteries. Case report

Blood flow rate and wall shear stress in seven major cephalic arteries of humans

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