Malformations of the Internal Carotid Artery: Case Report

Internal carotid artery (ICA) malformations and their effects on carotid artery stenosis and cerebrovascular diseases are still under investigation. Unilateral and bilateral variation in the course and elongation of the cervical (extracranial) part of the ICA leading to its tortuosity, kinking and coiling or looping is not a rare condition, which could be caused by both embryological and acquired factors. Some patients with such variations may be asymptomatic while others can develop cerebrovascular symptoms due to carotid stenosis affecting cerebral circulation. The risk of transient ischemic attacks in patients with carotid stenosis is high and its surgical correction is indicated for the prevention of ischemic stroke. Detection of developmental variations of the ICA and evaluation of its stenotic areas are very important for surgical interventions and involve specific diagnostic imaging techniques for vascular lesions including contrast arteriography, duplex ultrasonography and magnetic resonance angiography. The surgical technique of resection of tortuous segment, with dilatation and reimplantation has become the method of choice in treating carotid kinking and coiling. Common morphological pathologies such as kinking and coling must be treated surgically.