J Clin Neurol.  2009 Sep;5(3):149-150. 10.3988/jcn.2009.5.3.149.

Common Carotid Artery Agenesis: Duplex Ultrasonographic Findings

• Yim SJ
• Ryu JH
• Baik JS
• Kim JY
• Park JH
• Han SW

• KMID: 2045422
• DOI: http://doi.org/10.3988/jcn.2009.5.3.149

Abstract

BACKGROUND
Agenesis of the common carotid artery (CCA) resulting in separation of the origin of the external carotid artery (ECA) and internal carotid artery (ICA) from the aortic arch is rare. Fewer than 25 cases have been reported, and correlative ultrasound data were available for only 1 of them. CASE REPORT: A 52-year-old woman visited the hospital with a 3-day history of vertigo and headache. Color-coded duplex ultrasonography performed to evaluate the carotid and vertebral arteries revealed a normal configuration on the left side. However, the right CCA could not be found; instead, there were two vessels of approximately equal size in close proximity to each other. The cerebral angiographic findings were consistent with the ultrasonographic findings. The ECA and ICA originated directly from the brachiocephalic trunk, and the ECA arose proximal to the ICA. CONCLUSIONS: The ultrasonographic findings revealed absence of the CCA, the ECA and ICA originating separately from the aortic arch. Color-coded duplex ultrasonography appears to be an effective and sensitive method for detecting absence of the CCA. These findings should help to further our understanding of the embryologic development of the carotid arteries.

Keyword

common carotid artery agenesis; ultrasonography; angiography

MeSH Terms

Angiography
Aorta, Thoracic
Brachiocephalic Trunk
Carotid Arteries
Carotid Artery, Common
Carotid Artery, External
Carotid Artery, Internal
Female
Headache
Humans
Middle Aged
Vertebral Artery
Vertigo

Figure

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  Fig. 1 Sonographic and angiographic findings of common carofid artery agenesis. (A) Color-coded duplex ultrasonography showing absence of the right common carotid artery (CCA). Instead, there are two vessels of approximately equal size in close proximity to each other. One vessel (B) shows a high-resistance flow pattern consistent with the external carotid artery (ECA), while the other vessel (C) shows a low-resistance flow pattern consistent with the internal carotid artery (ICA). (D) Cerebral angiography showing that the ICA (I, arrows) and ECA (E) originate directly from the brachiocephalic trunk, and that the ECA arises proximal to the ICA. The vertebral artery (V) is also shown.

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