Ochsner J L, Hughes J P, Leonard G L, Mills N L
Ann Surg. 1977 Jun;185(6):684-91. doi: 10.1097/00000658-197706000-00011.
Elongation with kinking of the internal carotid artery is not an uncommon finding. Cerebral vascular insufficiency has been reported secondary to this abnormality. Although arteriosclerosis is a frequent cause in adults, the etiology in children has never been explained. Three children with significant kinking of the internal carotid artery are reported here. Each underwent surgical correction by excision and reconstruction. Histological review showed the elastic tissue to be disrupted, diminished in amount, and unevenly distributed. Retrospective examination of this elastic tissue dysplasia showed it to be localized, there being normal morphology both proximally and distal to the involved area. There was recurrence of elongation and kinking in one patient due to incomplete excision. Correction was accomplished after re-excision of the involved tissue with a vein graft interposition. From this study, it can be concluded that elongation and kinking of the internal carotid artery in children is secondary to elastic tissue dysplasia. It is imperative that the entire involved area be removed in order to prevent recurrence. The excised specimen should be studied histologically with elastic tissue stains. Such stains cannot be performed as frozen section. Should permanent studies show the margins of resection not to be beyond the dysplastic tissue, careful followup of these children is essential to recognize recurrence.
颈内动脉延长伴扭结并非罕见的发现。已有报道称这种异常继发脑血管供血不足。虽然动脉硬化是成人的常见病因，但儿童的病因从未得到解释。本文报道了3例颈内动脉明显扭结的儿童病例。每例均通过切除和重建进行手术矫正。组织学检查显示弹性组织遭到破坏，数量减少且分布不均。对这种弹性组织发育异常的回顾性检查显示其为局限性的，受累区域近端和远端的形态均正常。1例患者因切除不完全而出现延长和扭结复发。再次切除受累组织并置入静脉移植物后完成了矫正。从这项研究可以得出结论，儿童颈内动脉延长和扭结继发于弹性组织发育异常。必须切除整个受累区域以防止复发。切除的标本应用弹性组织染色进行组织学研究。这种染色不能在冰冻切片上进行。如果永久性研究显示切除边缘未超出发育异常组织，则对这些儿童进行仔细随访对于识别复发至关重要。
