Agenesis of the internal carotid artery with transcavernous anastomosis presenting with an anterior communicating artery aneurysm--a case report and review of the literature

Clinical Neurology and Neurosurgery
Nobutaka HorieIzumi Nagata

Abstract

Arterial communication between cavernous segments of the carotid arteries associated with unilateral agenesis of the internal carotid artery (ICA) is extremely rare. We herein present a case of unilateral ICA agenesis with transcavernous anastomosis that presents with an anterior communicating artery (ACoA) aneurysm, and discuss its embryogeny and clinical implications. A 55-year-old woman with no significant medical history was admitted to our hospital for further examination of agenesis of the left ICA, which was detected in a routine medical examination. She was free of clinical symptoms and had no neurological deficits. Radiological evaluation revealed agenesis of the left ICA with transcavernous anastomosis. Moreover, an incidental multilobulated aneurysm was detected at the ACoA. She underwent microsurgical clipping for this aneurysm, and the post-operative course was uneventful. Investigation of collateral pathways helps our understanding of the segmental nature of carotid artery development. Recognition of this anomaly also has important implications in the surveillance and detection of associated cerebral aneurysms.

References

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Citations

Dec 3, 2011·Journal of Neurosurgery. Pediatrics·R Shane TubbsAaron A Cohen-Gadol
Jan 31, 2012·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Eun Joo LeeSung Jin Kim
Oct 17, 2015·Interventional Neuroradiology : Journal of Peritherapeutic Neuroradiology, Surgical Procedures and Related Neurosciences·Masakazu OkawaTooru Inoue
Apr 20, 2016·Interventional Neuroradiology : Journal of Peritherapeutic Neuroradiology, Surgical Procedures and Related Neurosciences·Ibrahim Ilker OzZuhal Erdem
Sep 20, 2019·Surgical and Radiologic Anatomy : SRA·Benjamin HebantRomain Lefaucheur

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