Zink Walter E, Komotar Ricardo J, Meyers Phillip M
Department of Radiology, Weill Medical College of Cornell University, New York, New York, USA.
J Neuroimaging. 2007 Apr;17(2):141-7. doi: 10.1111/j.1552-6569.2007.00092.x.
Abnormal arterial flow dynamics and intracranial collateral pathways can be seen in patients with congenital internal carotid artery (ICA) aplasia or hypoplasia. Here we seek to evaluate whether ICA aplasia/hypoplasia is associated with an increased prevalence of intracranial saccular aneurysm relative to carotid rete mirabile.
We combined our experience of three cases with 148 previous publications to form a retrospective series including 132 cases of ICA aplasia, 33 cases of ICA hypoplasia, and 34 cases of carotid rete mirabile.
After excluding cases lacking angiograms, ICA aplasia/hypoplasia was more commonly associated with aneurysm (45/158, 27.8%) compared with rete mirabile (2/34, 5.9%). A significantly greater overall aneurysm prevalence was seen among ICA aplasia/hypoplasia patients age 30 years or older (38/101, 36.6%) than in younger individuals (7/48, 14.6%).
Intracranial saccular aneurysm is more strongly associated with ICA aplasia/hypoplasia than rete mirabile. An increased aneurysm prevalence among older individuals with ICA aplasia/hypoplasia suggests an acquired etiology. Magnetic resonance angiography (MRA) is recommended in the initial evaluation of ICA aplasia/hypoplasia to evaluate for intracranial saccular aneurysm, particularly after the third decade of life.
先天性颈内动脉（ICA）发育不全或发育不良的患者可出现异常的动脉血流动力学及颅内侧支循环途径。在此，我们旨在评估相对于颈动脉奇网，ICA发育不全/发育不良是否与颅内囊状动脉瘤的患病率增加相关。
我们将3例患者的经验与之前的148篇文献相结合，形成了一个回顾性系列研究，其中包括132例ICA发育不全、33例ICA发育不良及34例颈动脉奇网患者。
排除缺少血管造影的病例后，ICA发育不全/发育不良患者合并动脉瘤（45/158，27.8%）的情况比颈动脉奇网患者更为常见（2 / 34，5.9%）。30岁及以上的ICA发育不全/发育不良患者的总体动脉瘤患病率（占比38 / 101，36.6 %）显著高于较年轻者（占比7 / 48，14.6 %）。
颅内囊状动脉瘤与ICA发育不全 /发育不良的相关性比与颈动脉奇网的更强。ICA发育不全/发育不良的老年患者中动脉瘤患病率增加提示病因是后天获得性的。建议对ICA发育不全/发育不良患者进行初步评估时采用磁共振血管造影（MRA）来评估颅内囊状动脉瘤，尤其是在30岁后。
