Sonne James W, Kaiser Helen, Williams Shanna
Biomedical Sciences, University of South Carolina School of Medicine Greenville, Greenville, USA.
Cureus. 2021 Aug 11;13(8):e17090. doi: 10.7759/cureus.17090. eCollection 2021 Aug.
The internal carotid arteries are one of the primary suppliers of the Circle of Willis and cerebral blood flow, but the rare case of agenesis of the internal carotid artery can impair the functional redundancies of cerebral blood supply. In this study, routine, medical education-focused cadaveric dissection of an 80-year-old male cadaver (cause of death was ventricular tachycardia) was performed. A case of agenesis of the left internal carotid artery and the carotid canal was identified. Upon investigation, we found that the compensatory pattern of irrigation in the Circle of Willis did not conform to previously described cases in the scientific literature. Further literature review suggested that such agenesis can be associated with a wide range of conditions from stroke, migraine, tinnitus, and Horner's syndrome. Due to the altered blood flow pattern, we caution the reading physician regarding the potential for ischemia and iatrogenic damage, particularly of the pituitary gland and eye. We suggest the use of neuroangiographic imaging in cases of agenesis of an internal carotid artery.
颈内动脉是 Willis 环和脑血流的主要供血动脉之一，但颈内动脉发育不全的罕见病例可能会损害脑供血的功能冗余。在本研究中，对一名 80 岁男性尸体（死因是室性心动过速）进行了以医学教育为重点的常规尸体解剖。发现一例左侧颈内动脉和颈动脉管发育不全的病例。经调查，我们发现 Willis 环的代偿性灌注模式与科学文献中先前描述的病例不符。进一步的文献综述表明，这种发育不全可能与中风、偏头痛、耳鸣和霍纳综合征等多种病症有关。由于血流模式改变，我们提醒阅读本文的医生注意缺血和医源性损伤的可能性，特别是垂体和眼睛的损伤。我们建议在颈内动脉发育不全的病例中使用神经血管造影成像。
