Karotid kanal çapı anterior serebral vasküler varyasyonların ve anevrizmaların gösterimesinde yol gösterici olabilir mi?

Year 2021, Volume: 12 Issue: 1, 42 - 49, 31.03.2021

Gizem Kuşçuoğlu , Lale Damgacı

https://doi.org/10.18663/tjcl.861566

Abstract

Amaç: Karotid kanal çapının kanal çapında değişikliğe neden olabilecek serebral vasküler varyasyon veya anevrizması olmayan hastalarda ölçülmesi ve kanal çapındaki değişikliklerin serebral vasküler anevrizma ve varyasyonların göstergesi olup olamayacağının belirlenmesi amaçlandı.
Gereç ve Yöntemler: Yedi yüz beyin-boyun bilgisayarlı tomografi incelemesi retrospektif olarak değerlendirildi. Hastaların 283’ü (40.4%) kadın, 417’si (59.6%) erkekti. İki taraflı karotid kanal çapı ölçüldü. Serebral vasküler varyasyonlar ve anevrizmalar kaydedildi.
Bulgular: Sağ karotid kanal çapı tüm hastalarda 5.631±0.502mm, erkeklerde 5.797±0.475mm ve kadınlarda 5.388±0.441mm; sol karotid kanal çapı tüm hastalarda 5.666±0.512mm, erkeklerde 5.825±0.492mm ve kadınlarda 5.432±04.49mm bulundu (p=0.039, <0.001 ve<0.001).
Vasküler hipoplazilerde ve posterior komünikan arter (PCom) dışındaki diğer vasküler agenezilerde, Moyamoya hastalığında, anterior ve orta serebral arter anevrizmalarında karotid kanal dardır.
Fetal orjinli posterior serebral arter varlığında, PCom dışındaki dolikoektazilerde, anterior komünikan arter (ACom) varyasyon ve anevrizmalarında, internal serebral arter anevrizmasında karotid kanal geniştir.
PCom agenezisi, anterior serebral arter A2 trifukasyonu ve ACom fenestrasyonu sağda dar kanal solda geniş kanal ile birliktelik göstermektedir.
Sonuç: Karotid kanal çapındaki anormallikler serebral vasküler varyasyon ve anevrizmaların göstergesi olabilir. Karotid kanal anormalliklerinde artan anevrizma insidansı daha geniş hasta gruplarında daha geniş çalışmaların gerekliliğini göstermektedir.

Keywords

serebral, vasküler, karotid, kanal, BTA

Can carotid canal diameter be an indicator of anterior cerebral vascular variations and abnormalities?

Abstract

Aim: To measure the bony carotid canal diameters in people without any cerebral vascular variations or aneurysms that would affect the bony carotid canal and to determine whether the variations of bony carotid canal width could be an indicator of cerebral vascular aneurysyms and variations.
Material and Methods: Seven-hundred neck-brain CT angiographies were assessed retrospectively. Of the patients, 283 (40.4%) were women and 417 (59.6%) were men. Bilateral bony carotid canal diameter was measured. Cerebral vascular variations and aneurysms were recorded.
Results: Normal canal diameter on the right, in all patients was 5.631±0.502mm, in males 5.797±0.475mm and 5.388±0.441mm in females; on the left side, 5.666±0.512mm overall, 5.825±0.492mm in males and 5.432±04.49mm in females (p=0.039, <0.001 and <0.001 consequently).
In vascular hypoplasias, in all other vascular agenesias other than posterior communicating (Pcom) artery, in Moyamoya disease, in anterior and middle cerebral artery aneurysms the canal is narrow.
In the presence of fetal originated vessels, in dolichoectasias of vessels, except PCom, in all anterior communicating artery (ACom) variations and aneurysms, in internal cerebral artery aneurysm the canal is wide.
PCom agenesia, anterior cerebral artery A2 trifurcation and ACom fenestration is accompanied by narrow canal on the right and wide canal on the left.
Conclusion
Abnormal canal diameter may indicate to vascular variation or aneurysm. The increased incidence of aneurysm in carotid canal anomalies implicates of the necessity of further studies with larger groups.

Keywords

cerebral, vascular, carotid, canal, CTA

References

• 1. Bhat DI, Somanna S, Kovoor JME. Bilateral hypoplasia of the internal carotid artery. Indian J Radiol Imaging 2011; 21: 257–60.
• 2. Simon J. Dimmick, Kenneth C. Faulder. Normal Variants of the Cerebral Circulation at Multidetector CT Angiography. RadioGraphics 2009; 29: 1027-43
• 3. Watanabe A, Tomohiro O, Koizumi K et al. Bony carotid canal hypoplasia in patients with moyamoya disease. J Neurosurg Pediatrics 2010; 5: 591–4.
• 4. Dianbin Hou, Yu Mei, Yongqiang Ji et al. Congenital internal carotid artery hypoplasia Medicine (Baltimore) 2019; 98: 13986
• 5. Motoshima S, Noguchi T, Kawashima M et al. Narrowed petrous carotid canal detection for the early diagnosis of moyamoya disease. Fukuoka Igaku Zasshi 2012; 103: 206-14.
• 6. Porto FH, Silva MN, Domingues JR et al. Themissed missing hole. Arq Neuropsiquiatr 2012; 70: 467-9.
• 7. Tanaka H, Fujita N, Enoki T. Relationship between variations in the circle of Willis and flow rates in internal carotid and basilar arteries determined by means of magnetic resonance imaging with semi-automated lumen segmentation: Reference data from 125 healthy volunteers. AJNR 2006; 27: 1770-5.
• 8. Fahy P, McCarthy P, Sultan S et al. An experimental investigation of the hemodynamic variations due to aplastic vessels within three-dimensional phantom models of the circle of Willis. Ann Biomed Eng 2014; 42: 123-38.
• 9. Kane AG, Dillon W, Barkovich AJ. Reduced caliber of the internal carotid artery: a normal finding with ipsilateral absence or hypoplasia of the A1 segment. American Journal of Neuroradiology 1996; 17: 1295-301
• 10. Pico F, Labreuche J, Cohen A et al. GENIC Investigators. Intracranial arterial dolichoectasia is associated with enlarged descending thoracic aorta. Neurology 2004; 63: 2016-21.
• 11. Nakamura Y, Hirayama T, Ikeda K. Clinicoradiologic Features of Vertebrobasilar Dolichoectasia in Stroke PatientsJ. Stroke and Cerebrovascular Diseases 2010; 21: 5-10
• 12. Khan AA, Asari MA, Pasha MA. A case of bilateral absence of carotid canals in human skull. Bangladesh Journal of Medical Science 2016; 15: 275
• 13. Pascalau R, Padurean VA, Bartos D, Bartos A, Szabo AB. The Geometry of the Circle of Willis Anatomical Variants as a Potential Cerebrovascular Risk Factor. Turk Neurosurg 2018; 2: 1-8
• 14. Horikoshi T, Akiyama I, Yamagata Z et al. Magnetic resonance angiography evidence of sex linked variations in the circle of Willis and occurence of cerebral aneurysms. J Neurosurg 2002; 96: 697-703.
• 15. Krasny A, Nensa F, Sandalcıoglu IE et al. Association of aneurysms and variations of the A1 segment. J Neurointerv Surg 2014; 6: 178-183.
• 16. Swathan JP, Sani AF, Swatan E. Anatomical variations of circle of Willis is common in patients with intracranial aneurysm: Initial registry data from tertiary health center, Surabaya, Indonesia. JNeurological Sciencies 2017; 381: 953
• 17. Aktürk Y, Fırat MM, Güven ME, Beyhan M. Relation of the incidence of congenital variations and anomalies with intracranial aneurysms in intracranial arteries. Dicle Tıp Dergisi 2016; 43: 515-20
• 18. Bor AS, Velthius BK, Majoie CB, et al. Configuration of intracranial arteries and development of aneurysms: a follow-up study. Neurology 2008; 70: 700-5.
• 19. Lazzaro MA, Ouyang B, Chen M. The role of Willis anomalies in cerebral aneurysm rupture. J Neuro Interv Surg 2012; 4: 22-6.
• 20. Kim DW, Kim SD. Association between internal carotid artery morphometry and posterior communicating artery aneurysm. Yonsei Med J 2007; 48: 634–8.
• 21. Flores BC, Scott WW, Eddleman CS et al. The A1-A2 Diameter Ratio May Influence Formation and Rupture Potential of Anterior Communicating Artery Aneurysms Neurosurgery 2013; 73: 845–53.
• 22. Han A, Yoon DA, Kim ES, et al. Value of CT angiography for the detection of intracranial vascular lesions in patients with acute severe headache. Eur Radiol 2013; 23: 1443–9.