Displaying publications 1 - 20 of 31 in total

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  1. Luh HT, Yang ST, Lu YH, Lu YC, Chan JY, Tu YK, et al.
    Clin Neuroradiol, 2023 Jun;33(2):319-325.
    PMID: 36056108 DOI: 10.1007/s00062-022-01211-9
    PURPOSE: Rete middle cerebral artery (MCA) anomaly is characterized by a web-like network of arteries involving the first MCA segment (M1) and a normal downstream MCA. The detailed composition of this anomaly and the hemodynamic impacts on cerebral perfusion are rarely addressed. The purpose of this study was to elucidate the anatomical and hemodynamic perspectives of the rete MCA anomaly.

    METHODS: From August 2020 to December 2021, 4 rete MCA anomalies were identified at Shuang Ho hospital. Clinical information, perfusion magnetic resonance (MR) imaging, and angiographic images were collected. Detailed angioarchitecture, including types of arterial feeders and extent of rete involvement, were analyzed based on three-dimensional volume-rendering reconstruction images obtained from the catheter-based angiographies.

    RESULTS: Despite their variable clinical presentations (two hemorrhage, one ischemia, and one asymptomatic), all cases shared common angiographic findings as follows: (1) the internal carotid artery did not connect directly to the rete, (2) the anterior choroidal artery (AChA) was the artery constantly supplying the rete and (3) there was a watershed zone shift toward MCA territory. The perfusion MR cerebral blood flow map was symmetric in all studied cases.

    CONCLUSION: The AChA is an artery constantly supplying the rete, which suggests that the angioarchitectural features associated with this anomaly may be the result of both congenital and acquired compensatory processes. Cerebral perfusion remains preserved at the lesion side, despite angiographic evidence of watershed zone shift. These findings will be important for making better clinical judgments about this condition.

    Matched MeSH terms: Carotid Artery, Internal
  2. Anusha B, Baharudin A, Philip R, Harvinder S, Shaffie BM
    Surg Radiol Anat, 2014 Jul;36(5):419-27.
    PMID: 24146215 DOI: 10.1007/s00276-013-1214-1
    The sphenoid sinus, one of the posterior groups of sinuses, has long been regarded as a 'neglected sinus' due to the anatomical location, poor understanding and poor accessibility, till the advent of endoscopes and modern imaging techniques. Increasing knowledge and greater understanding of this sinus has permitted an evolution in surgical practices and boundaries. Various literatures of the past report a great variety of rates of pneumatization, rates of optic nerve protrusion and dehiscence, as well as internal carotid artery (ICA) protrusion and dehiscence. One similarity noted among these studies is that the rates vary according to the ethnicity of the patients. Recommendations have also been made along the way with regard to modified surgical techniques. This review aims to describe the pneumatization of sphenoid sinus and the topographical relation of the optic nerve and ICA in different populations.
    Matched MeSH terms: Carotid Artery, Internal/anatomy & histology
  3. Sia SF, Zhao X, Li R, Zhang Y, Chong W, He L, et al.
    Proc Inst Mech Eng H, 2016 Nov;230(11):1051-1058.
    PMID: 28095764 DOI: 10.1177/0954411916671752
    BACKGROUND: Internal carotid artery stenosis requires an accurate risk assessment for the prevention of stroke. Although the internal carotid artery area stenosis ratio at the common carotid artery bifurcation can be used as one of the diagnostic methods of internal carotid artery stenosis, the accuracy of results would still depend on the measurement techniques. The purpose of this study is to propose a novel method to estimate the effect of internal carotid artery stenosis on the blood flow based on the concept of minimization of energy loss.

    METHODS: Eight internal carotid arteries from different medical centers were diagnosed as stenosed internal carotid arteries, as plaques were found at different locations on the vessel. A computational fluid dynamics solver was developed based on an open-source code (OpenFOAM) to test the flow ratio and energy loss of those stenosed internal carotid arteries. For comparison, a healthy internal carotid artery and an idealized internal carotid artery model have also been tested and compared with stenosed internal carotid artery in terms of flow ratio and energy loss.

    RESULTS: We found that at a given common carotid artery bifurcation, there must be a certain flow distribution in the internal carotid artery and external carotid artery, for which the total energy loss at the bifurcation is at a minimum; for a given common carotid artery flow rate, an irregular shaped plaque at the bifurcation constantly resulted in a large value of minimization of energy loss. Thus, minimization of energy loss can be used as an indicator for the estimation of internal carotid artery stenosis.

    Matched MeSH terms: Carotid Artery, Internal/physiopathology
  4. Sridharan R, Low SF, Mohd MR, Kew TY
    Singapore Med J, 2014 Oct;55(10):e165-8.
    PMID: 25631906
    Epistaxis is commonly encountered in otorhinolaryngologic practice. However, severe and recurrent epistaxis is rarely seen, especially that originating from a pseudoaneurysm of the intracavernous internal carotid artery (ICA). We herein present the case of a 32-year-old man who was involved in a motor vehicle accident and subsequently developed recurrent episodes of profuse epistaxis for the next three months, which required blood transfusion and nasal packing to control the bleeding. Computed tomography angiography revealed a large intracavernous ICA pseudoaneurysm measuring 1.7 cm × 1.2 cm × 1.0 cm. The patient underwent emergent four-vessel angiography and coil embolisation and was discharged one week later without any episode of bleeding. He remained asymptomatic after three-month and one‑year intervals. This case report highlights a large intracavernous ICA pseudoaneurysm as a rare cause of epistaxis, which requires a high index of suspicion in the right clinical setting and emergent endovascular treatment to prevent mortality.
    Matched MeSH terms: Carotid Artery, Internal/pathology*; Carotid Artery, Internal/surgery
  5. Anusha B, Baharudin A, Philip R, Harvinder S, Shaffie BM, Ramiza RR
    Surg Radiol Anat, 2015 Dec;37(10):1183-90.
    PMID: 25990686 DOI: 10.1007/s00276-015-1494-8
    Failure of a surgeon to understand the local variations of the anatomical landmarks of the sphenoid sinus is a potential risk factor to cause damage to the optic nerve (ON) or internal carotid artery (ICA) that lies on the walls of the sphenoid sinus. The aim of this study was to identify the anatomical variants of the sphenoid sinus and its related surrounding structures among the Southeast Asian (SEA) population, based on computed tomography (CT) scans.
    Matched MeSH terms: Carotid Artery, Internal
  6. Che Ani MF, Kumar R, Md Noh MSF, Muda AS
    BJR Case Rep, 2018 Mar;4(3):20170058.
    PMID: 31489208 DOI: 10.1259/bjrcr.20170058
    Carotid-cavernous fistulas (CCFs) are vascular shunts between the carotid arterial system with direct drainage into the cerebral venous system, mainly to the cavernous sinus. Direct CCF is a well-recognised complication following head trauma. Classically in direct or traumatic CCF, vessel wall tear occurs at the cavernous segment of the internal carotid artery, between the fixed and free segment. Tears at the supraclinoid segment are rare. We report a case of an internal carotid artery supraclinoid segment pseudoaneurysm, with a direct communication with the cavernous sinus, draining into the superior ophthalmic vein.
    Matched MeSH terms: Carotid Artery, Internal
  7. Vashu R, Tan S, Wong AS
    J Clin Neurosci, 2009 Jul;16(7):960-2.
    PMID: 19346131 DOI: 10.1016/j.jocn.2008.09.013
    We report on two patients with intra-operative rupture of cerebral aneurysms that were managed by microsuturing. This is one of only a few reports of successful direct repair using suturing. We found that stitching remains an option to repair a tear of a saccular part of an aneurysm and a torn neck of a blister-like aneurysm, and thus this technique can be considered before sacrificing the artery.
    Matched MeSH terms: Carotid Artery, Internal/surgery*
  8. Abdullah A, Putra SH, Saim L
    Med J Malaysia, 2006 Mar;61(1):84-7.
    PMID: 16708739 MyJurnal
    Post-traumatic pseudoaneurysms of internal carotid arteries are uncommon. The patients may present with massive epistaxis due to rupture of the aneurysm into the sphenoid sinus. Early diagnosis and treatment is mandatory as the likelihood of exsanguinations increases with each subsequent episode of epistaxis. The clinical features of unilateral blindness and massive epistaxis after head injury should indicate the diagnosis. The high mortality of this entity underlines the importance of early angiography in these patients to confirm this diagnosis. We present 3 cases of post-traumatic aneurysm of the ICA.
    Matched MeSH terms: Carotid Artery, Internal/physiopathology*
  9. Mann GS, Philip R, Balachandran A
    Med J Malaysia, 2005 Aug;60(3):367-9.
    PMID: 16379195
    Epistaxis is a common problem encountered in clinical practice. It is usually self-limiting and is usually controlled with conservative measures such as nasal compression or ice-packs. Occasionally nasal packing is required. It is rarely severe enough that surgical intervention is warranted. The following report illustrates a patient who presented to us with a rare cause of life-threatening epistaxis that is, a post-traumatic pseudoaneurysm who finally required surgical intervention to control the bleeding.
    Matched MeSH terms: Carotid Artery, Internal*
  10. Lee NNA, Long G, Ngai S, Sahrir S, Parker A, Lamont AC
    Med J Malaysia, 2004 Dec;59(5):685-7.
    PMID: 15889576
    A 7-year-old girl with tonsillar infection with antibiotics. Two weeks later, there was a right sided neck lump. Computed tomography scans demonstrated a predominantly hypodense right retropharyngeal area with peripheral enhancement and mass effect. There was intense enhancement within the postero-superior aspect of the lesion which was continuous with the right internal carotid artery. Ultrasound demonstrated tapering of the right internal carotid artery. Magnetic resonance imaging and magnetic resonance arteriography showed a right internal carotid artery pseudoaneurysm. Surgical exploration confirmed the finding. This case highlights an unusual presentation of an internal carotid pseudoaneurysm and how imaging provided the diagnosis.
    Matched MeSH terms: Carotid Artery, Internal*
  11. Tai MS, Sia SF, Kadir KAA, Idris MI, Tan KS
    Case Rep Neurol, 2020 12 14;12(Suppl 1):149-155.
    PMID: 33505287 DOI: 10.1159/000501069
    Background: Coughing due to respiratory tract infections may lead to internal carotid artery (ICA) dissection.

    Aim: We are presenting a patient with an unusual cough-induced ICA dissection.

    Case Report: A 42-year-old health care worker presented with bilateral hand numbness which resolved spontaneously. This initial episode was followed 9 days later with intermittent episodes of right hand and leg weakness with speech difficulty. Two days later, he had another episode of speech difficulty. One week prior to the first presentation, he had upper respiratory tract infection with ongoing strong bouts of coughing. Magnetic resonance imaging (MRI), diffusion-weighted imaging (DWI), and apparent diffusion coefficient (ADC) of the brain showed early ischaemic changes at the left frontal and left parietal regions. MR angiography (MRA) showed high signal intensity at the left proximal ICA and poor flow beyond the left carotid bulb. Cerebral angiography revealed left ICA dissection.

    Conclusion: Proper identification of cough-induced extracranial ICA dissection is important because this is treatable.

    Matched MeSH terms: Carotid Artery, Internal; Carotid Artery, Internal, Dissection
  12. Sengupta BN
    Med J Malaya, 1971 Dec;26(2):139-43.
    PMID: 4260862
    Matched MeSH terms: Carotid Artery, Internal/anatomy & histology
  13. Bhatti MS, Tang TB, Chen HC
    Sci Rep, 2018 04 09;8(1):5713.
    PMID: 29632320 DOI: 10.1038/s41598-018-24141-4
    In this study, we reported a new technique based on laser speckle flowgraphy to record the ocular blood flow in rabbits under deep anesthesia, and proposed parameters to characterize retinal ischemia. We applied the proposed technique to study the correlation of blood flow between the eyes of normal non-anesthetized animals, and to characterize the occlusion of the internal carotid artery (ICA) and external carotid artery (ECA). We established a correlation in blood flow between the eyes of non-anesthetized animals, and derived two new parameters, namely, the laterality index and vascular perfusion estimate (VPE). Our experimental results from 16 eyes (of 13 New Zealand white rabbits) showed a reduction in ocular blood flow with a significant decrease in the VPE after the occlusion of the ECA (p 
    Matched MeSH terms: Carotid Artery, Internal/physiopathology
  14. Das S, Suri R, Kapur V
    Sao Paulo Med J, 2007 Nov 01;125(6):351-3.
    PMID: 18317606
    CONTEXT: The medial end of the posterior border of the sphenoid bone presents the anterior clinoid process (ACP), which is usually accessed for operations involving the clinoid space and the cavernous sinus. The ACP is often connected to the middle clinoid process (MCP) by a ligament known as the caroticoclinoid ligament (CCL), which may be ossified, forming the caroticoclinoid foramen (CCF). Variations in the ACP other than ossification are rare. The ossified CCL may have compressive effects on the internal carotid artery. Thus, anatomical and radiological knowledge of the ACP and the clinoid space is also important when operating on the internal carotid artery. Excision of the ACP may be required for many skull-based surgical procedures, and the presence of any anomalies such as ossified CCL may pose a problem for neurosurgeons.

    CASE REPORT: We observed the presence of ossified CCL in a skull bone. A detailed radiological study of the CCL and the CCF was conducted. Morphometric measurements were recorded and photographs were taken. The ACP was connected to the MCP and was converted into a CCF. Considering the fact that standard anatomy textbooks do not provide morphological descriptions and radiological evaluations of the CCL, the present study may be important for neurosurgeons operating in the region of the ACP.

    Matched MeSH terms: Carotid Artery, Internal/pathology*
  15. Nayak SB, Shetty SD
    Surg Radiol Anat, 2021 Mar;43(3):413-416.
    PMID: 33231750 DOI: 10.1007/s00276-020-02619-z
    Knowledge of variations of the internal carotid artery is significant to surgeons and radiologists. The internal carotid artery normally runs a straight course in the neck. Its anomalies can lead to its iatrogenic injuries. We report a case of a large loop of the internal carotid artery in a male cadaver aged about 75 years. The common carotid artery terminated by dividing it into the external carotid artery and internal carotid arteries at the level of the upper border of the thyroid cartilage. From the level of origin, the internal carotid artery coursed upwards, backwards and laterally, and formed a large loop behind the internal jugular vein. The variation was found on the left side of the neck and was unilateral. The uncommon looping of the internal carotid artery might result in altered blood flow to the brain and may lead to misperceptions in surgical, imaging, and invasive procedures.
    Matched MeSH terms: Carotid Artery, Internal/abnormalities*; Carotid Artery, Internal/embryology
  16. Ng, Chong-Guan, Govindasamy, Krishnan Gopala, Tai, Sharon Mei-Ling, Tan, Chong-Tin, Mariyam Niyaz
    Neurology Asia, 2013;18(2):143-151.
    MyJurnal
    Background and objectives: Radiation treatment in nasopharyngeal carcinoma (NPC) is known to be associated with increased prevalence of carotid stenosis. The objectives of the study was to determine the prevalence of radiation-induced extracranial carotid stenosis, plaque, carotid intima thickness (CIMT) in NPC patients; to explore whether the stenosis is due to direct effect of radiation rather than general tendency to atherosclerosis. Methods: This was a cross-sectional study conducted in the University Malaya Medical Centre from July 2011 to February 2012. The study subjects consisted of 47 NPC patients who were treated with radiation, and 47 healthy control. The patients and control had carotid duplex ultrasound and transcranial Doppler (TCD). Results: The mean age of the patients was 55.1 years, the time lapse from radiation was 76.7 ± 95.3 months. Internal carotid artery (ICA) and common carotid artery (CCA) stenosis of ≥50% was seen in 17.0% of patients vs 2.1 % of controls (p = 0.031), with 61.7% of patients and 19.1% of controls having plaque in ICA and CCA (p=0.004). CIMT was increased in 70.2% of patients and 44.7% of controls (p =0.022). Both the patient group and control had similar rate of intracranial stenosis of 12.8% in TCD.
    Conclusion: Extracranial internal carotid artery is the most common site of stenosis following radiotherapy in NPC. This suggests that local trauma from irradiation is the most important factor in predisposition to atherosclerosis following radiation therapy.
    Matched MeSH terms: Carotid Artery, Internal
  17. Sheau, Fung Sia, Yu, Zhang, Yi, Qian, Khairul Azmi Abd Kadir, Hazman Mohd Nor, Morgan, Michael Kerin
    Neurology Asia, 2014;19(3):241-247.
    MyJurnal
    Objective: To investigate the degree of stenosis of the internal carotid artery required for continuous blood flow in an interposition vein bypass to the middle cerebral artery. Methods: Computational fluid dynamics techniques were used to investigate a case of common carotid to middle cerebral artery brain bypass with varying degrees of internal carotid artery stenosis. Blood flow patterns across the patient-specific brain bypass were evaluated. Results: Simulation found that for cross section stenosis of less than 60%, no flow occurred in the bypass graft. Further narrowing of the internal carotid artery increased flow linearly within the bypass graft. There was significant energy loss and pressure gradient difference between the proximal and distal anastomosis sites of the bypass.
    Conclusion: Computational fluid dynamics helps us to quantify the flow distribution, wall shear stress and pressure gradient in brain bypass surgery. The angle of the distal anastomosis had no effect on hemodynamic indices, allowing this consideration to be ignored in modeling. This modeling technique is useful to estimate the required degree of stenosis in the artery that is to be occluded to ensure sustained flow in the bypass. This will be of importance where there is staged surgery with a time interval between the bypass and the definitive internal carotid artery occlusion.
    Matched MeSH terms: Carotid Artery, Internal
  18. Khairuddin NH, Sullivan M, Pollock PJ
    Ir Vet J, 2017 04 20;70:12.
    PMID: 28439406 DOI: 10.1186/s13620-017-0090-0
    BACKGROUND: In horses, the extracranial and intracranial pathway of the internal carotid artery has been described. The extracranial pathway of the internal carotid artery begins at the carotid termination and runs on the dorsal surface of the medial compartment of the guttural pouch. Thereafter the internal carotid artery passes through the foramen lacerum to continue intracranially, forming part of the rostrolateral quadrants of the cerebral arterial circle (Circle of Willis). The objectives of this study were to define and record the anatomy of the carotid arterial tree and the internal carotid artery in donkeys using angiographic techniques. This is a prospective descriptive study on 26 cadaveric donkeys.

    METHODS: Twenty six donkey cadavers of mixed, age, sex and use presented for reasons unrelated to disease of the guttural pouch were subjected to carotid and cerebral angiography using rotational angiography. Rotational angiographic and 3 dimensional multiplanar reconstructive (3D-MPR) findings were verified with an arterial latex casting technique followed by dissection and photography.

    RESULTS: The following variations of the carotid arterial tree were identified: [1] the internal carotid and occipital arteries shared a common trunk, [2] the linguofacial trunk originated from the common carotid artery causing the common carotid artery to terminate as four branches, [3] the external carotid artery was reduced in length before giving rise to the linguofacial trunk, mimicking the appearance of the common carotid artery terminating in four branches, [4] the internal carotid artery originated at a more caudal position from the common carotid artery termination.

    CONCLUSION: Veterinarians should be aware that considerable variation exists in the carotid arterial tree of donkeys and that this variation may differ markedly from that described in the horse.

    Matched MeSH terms: Carotid Artery, Internal
  19. Mohammad AA, Yasuhiro Y, Seng LB, Rajagopal N, Yoko K
    Asian J Neurosurg, 2019 5 31;14(2):415-421.
    PMID: 31143255 DOI: 10.4103/ajns.AJNS_155_18
    Introduction: Surgical outcome and ischemic complications of Internal carotid Posterior Communicating (IC PC) and anterior choroidal aneurysms have been questionable due to frequent occlusion of the anterior choroid artery and also due to low incidence of true anterior choroid artery aneurysms. The present series describes the postoperative outcome after clipping of such aneurysms at a single centre.

    Methods: A retrospective analysis of 73 cases with IC PC and Anterior choroidal aneurysms performed at a Fujita Health University, Banbuntane Hotokukai Hospital, Nagoya, Aichi, Japan from 2014 to 2018 have been studied and emphasis is made on the demography and ischemic complications.

    Results: A total of 73 patients with IC PC and anterior choroidal aneurysms were studied, out of which 57 patient had a true IC PC aneurysm, 14 patients had aneurysms involving the anterior choroidal artery and only 2 patients had aneurysms which involved both the IC PC and the anterior choroidal arteries. None of the patients had a permanent Anterior Choroidal Artery syndrome, whereas only 2 out of the 73 patients had postoperative complications in the form of transient hemiparesis.

    Conclusion: Ischemic complications following surgical clipping of IC PC and anterior choroidal aneurysms can be minimised by meticulous micro dissection to identify the anterior choroidal artery thus preserving the patency of the same.

    Matched MeSH terms: Carotid Artery, Internal
  20. Ong JL, Jalaludin S
    Malays J Med Sci, 2016 Mar;23(2):78-81.
    PMID: 27547119 MyJurnal
    The purpose is to describe a case of traumatic right extracranial internal carotid artery (EICA) pseudoaneurysm, which is a rare entity and the evolution of treatment from surgery to minimally invasive intervention by endovascular stenting and coiling. We reported a case of traumatic right EICA pseudoaneurysm who presented with multiple cranial nerve palsies. Multiple radiological examinations [including magnetic resonance imaging (MRI) with angiogram, computed tomography angiogram (CTA), and digital subtraction angiogram (DSA)] demonstrated right EICA pseudoaneurysm. The pseudoaneurysm was successfully treated with endovascular stenting and coiling. EICA pseudoaneurysm is a rare entity, and open surgery was the gold standard of treatment. Current technology allows endovascular stenting and coiling of pseudoaneurysm as an alternative treatment. It is minimally invasive, associated with lesser complications, better recovery and a shorter hospital stay.
    Matched MeSH terms: Carotid Artery, Internal
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