Ovchinnikov Nikolai A, Rao Ramesh T, Rao Suresh R
Anatomy & Cell Biology Unit, Department of Preclinical Sciences, Faculty of Medical Sciences, University of the West Indies, St. Augustine, Trinidad and Tobago, West Indies.
Head Face Med. 2007 Jul 25;3:29. doi: 10.1186/1746-160X-3-29.
Unilateral and bilateral variation in the course and elongation of the cervical (extracranial) part of the internal carotid artery (ICA) leading to its tortuosity, kinking and coiling or looping is not a rare condition, which could be caused by both embryological and acquired factors. Patients with such variations may be asymptomatic in some cases; in others, they can develop cerebrovascular symptoms due to carotid stenosis affecting cerebral circulation. The risk of transient ischemic attacks in patients with carotid stenosis is high and its surgical correction is indicated for the prevention of ischemic stroke. Detection of developmental variations of the ICA and evaluation of its stenotic areas is very important for surgical interventions and involves specific diagnostic imaging techniques for vascular lesions including contrast arteriography, duplex ultrasonography and magnetic resonance angiography. Examination of obtained images in cases of unusual and complicated variations of vascular pattern of the ICA may lead to confusion in interpretation of data. Awareness about details and topographic anatomy of variations of the ICA may serve as a useful guide for both radiologists and vascular surgeons. It may help to prevent diagnostic errors, influence surgical tactics and interventional procedures and avoid complications during the head and neck surgery. Our present study was conducted with a purpose of updating data about developmental variations of the ICA. Dissections of the main neurovascular bundle of the head and neck were performed on a total 14 human adult cadavers (10 - Africans: 7 males & 3 females and 4 - East Indians: all males). Two cases of unilateral congenital elongation of the cervical part of the ICA with kinking and looping and carotid stenoses were found only in African males. Here we present their detailed case reports with review of the literature.
颈内动脉（ICA）颈部（颅外）段走行和长度的单侧及双侧变异，导致其迂曲、扭结、盘绕或成袢，并非罕见情况，这可能由胚胎学因素和后天因素共同引起。在某些情况下，有此类变异的患者可能无症状；而在其他情况下，由于颈动脉狭窄影响脑循环，他们可能会出现脑血管症状。颈动脉狭窄患者发生短暂性脑缺血发作的风险很高，手术矫正可预防缺血性卒中。检测ICA的发育变异并评估其狭窄区域对于手术干预非常重要，这涉及用于血管病变的特定诊断成像技术，包括造影动脉造影、双功超声检查和磁共振血管造影。在ICA血管模式出现异常和复杂变异的情况下，对所获得图像的检查可能会导致数据解读混乱。了解ICA变异的细节和局部解剖结构，对放射科医生和血管外科医生都可能是有用的指导。这可能有助于防止诊断错误，影响手术策略和介入程序，并避免头颈外科手术期间的并发症。我们目前的研究旨在更新关于ICA发育变异的数据。对总共14具成年人类尸体（10具非洲人尸体：7名男性和3名女性，以及4具东印度人尸体：均为男性）的头颈部主要神经血管束进行了解剖。仅在非洲男性中发现了2例ICA颈部单侧先天性延长伴扭结和成袢以及颈动脉狭窄的病例。在此，我们结合文献回顾呈现其详细病例报告。
