Top

Published in:

Open Access 01-03-2021 | Anatomic Variations

Surgical and embryological perspective of a big loop of internal carotid artery extending laterally beyond internal jugular vein

Authors: Satheesha B. Nayak, Surekha D. Shetty

Published in: Surgical and Radiologic Anatomy | Issue 3/2021

Abstract

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.

Agrawal R, Agrawal SK (2011) Dangerous anatomic variation of the internal carotid artery—a rare case report. Int J Anat Variat 4:174–176

Akpek S, Arat A, Morsi H, Klucznick RP, Strother CM, Mawad ME (2005) Self-expandable stent-assisted coiling of wide-necked intracranial aneurysms: a single-center experience. Am J Neuroradiol 26:1223–1231PubMed

Anne GO (1999) Diagnostic cerebral angiography, vol 2. Lippincott Williams & Wilkins, Philadelphia, pp 57–63

Beigelman R, Izaguirre AM, Robles M, Grana DR, Ambrosio G, Milei J (2010) Are kinking and coiling of carotid artery congenital or acquired? Int Angiol 61:107–112CrossRef

Bergman RA, Thompson SA, Afifi AK, Saadeh FA (1888) Compendium of human anatomic variations. Urban & Schwarzenberg, Baltimore, p 65

Cairney J (1924) Tortuosity of the cervical segment of the internal carotid artery. J Anat 59:87–96PubMedPubMedCentral

Carsuzaaa F, Dufoura X, Houpertb T, Ferriec J, Sapanetb M, Delbreilb A (2020) Major cerebral hypoperfusion on an internal carotid loop during an otologic surgery: a case report. Leg Med 42:101636CrossRef

Coulson W (1852) Peculiar disposition of the large vessels, producing a tremor at the root of the neck. Trans Path Soc Lond 3:302

Dungan DH, Heiserman JE (1996) The carotid artery: embryology, normal anatomy, and physiology. Neuroimag Clin N Am 6:789–799

10.

Figueiredo RR, Azevedo AA (2009) Retropharyngeal internal carotid artery: case report. Int Arch Otorhinolaryngol 13(1):104–106

11.

Hosokawa S, Mineta H (2010) Tortuous internal carotid artery presenting as a pharyngeal mass. J Laryngol Otol 124:1033–1036CrossRef

12.

Jackson JL (1933) Tortuosity of internal carotid artery and its relation to tonsillectomy. Can Med Ass J 29:475–479PubMed

13.

Kelly AB (1952) Tortuosity 0f the internal carotid artery in relation to the pharynx. J Laryngol Otol 40:15–23CrossRef

14.

Koskas F, Bahnini A, Walden R, Kieffer E (1993) Stenotic coiling and kinking of the internal carotid artery. Ann Vasc Surg 7:530–540CrossRef

15.

Metz H, Murray-Leslie RM, Bannister RG, Bull JWD, Marshall J (1961) Kinking of the internal carotid artery. Lancet 1:424–426CrossRef

16.

Munoz A, De Vergas J, Crespo J (2010) Imaging and clinical findings in patients with aberrant course of the cervical internal carotid arteries. Open Neuroimag J 4:174–181CrossRef

17.

Nayak SB (2010) Unusual looping of the internal carotid artery in relation to an enlarged lymph node. Int J Anat Variat 3:84–85

18.

Nayak SB, Kumar N (2018) Multiple loops of external and internal carotid arteries vulnerable in surgical and radiological procedures. Balkan Med J 35:285–286CrossRef

19.

Ozgur Z, Celik S, Govsa F, Aktug H, Ozgur T (2007) A study of the course of the internal carotid artery in the parapharyngeal space and its clinical importance. Head Neck Surg 264:1483–1489

20.

Picel AC, Davidson TM (2011) An aberrant internal carotid artery discovered during evaluation of obstructive sleep apnea: a report of 2 cases with consideration of a possible association. Ear Nose Throat J 90(1):29–31CrossRef

21.

Patil SP, Schneider H, Schwartz AR, Smith PL (2007) Adult obstructive sleep apnea: pathophysiology and diagnosis. Chest 132(1):325–337CrossRef

22.

Paulsen F, Tillmann B, Christofides C, Koebke J (2000) Curving and looping of the internal carotid artery in relation to the pharynx: frequency, embryology & clinical implications. J Anat 197:373–381CrossRef

23.

Radak D, Babic S, Tanaskovic S, Matic P, Sotirovic V (2012) Are the carotid kinking and coiling underestimated entities? Vojnosanit Pregl 69:616–619CrossRef

24.

Sadler TW (2018) Langman’s medical embryology, 14th edn. Wolters Kluwer Health, Philadelphia

25.

Shanley DJ (1992) Bilateral aberrant cervical internal carotid arteries. Neuroradiol 35:55–56CrossRef

26.

Singh R, Tubbs RS (2017) Effect of cervical siphon of external and internal carotid arteries. Craniofac Surg 28:1857–1860CrossRef

27.

Standring S (2016) Gray’s anatomy: the anatomical basis of clinical practice, 40th edn. Churchill Livingstone, Elsevier, Philadelphia

28.

Tillmann B, Christofides C (1995) The “dangerous loop” of the internal carotid artery. An anatomic study. HNO 43:601–604PubMed

29.

Vinnakota S, Giri BN, Neelee J (2011) A rare association of curving and looping of internal carotid artery and variation in the branching pattern of external carotid artery—a case report. Int J Biol Med Res 2:822–823

30.

Weibel J, Fields WS (1965) Tortuosity, coiling and kinking of the internal carotid artery. II. Relationship of morphological variation to cerebrovascular insufficiency. Neurology 15:462–468CrossRef

31.

Ziolkowska K, Bachvarov C, Sapundzhiev N, Genova P (2017) Bilateral tortuous internal carotid arteries—a case report, otorhinolaryngologic and general clinical implications. J IMAB 23(3):1657–1666CrossRef

Title: Surgical and embryological perspective of a big loop of internal carotid artery extending laterally beyond internal jugular vein
Authors: Satheesha B. Nayak
Surekha D. Shetty
Publication date: 01-03-2021
Publisher: Springer Paris
Published in: Surgical and Radiologic Anatomy / Issue 3/2021
Print ISSN: 0930-1038
Electronic ISSN: 1279-8517
DOI: https://doi.org/10.1007/s00276-020-02619-z

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Surgical and embryological perspective of a big loop of internal carotid artery extending laterally beyond internal jugular vein

Abstract

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 3/2021

Anatomy of peripancreatic arteries and pancreaticoduodenal arterial arcades in the human pancreas: a cadaveric study

Morphologic variants of the Cerebral Arterial Circle on computed tomographic angiography (CTA): a large retrospective study

Some observations over the article “Evaluation of the anastomoses between the ophthalmic artery and the middle meningeal artery by superselective angiography”

A report of a case: unusual portosystemic shunt in a hernia sac who has portal hypertension due to cirrhosis

Medial type persistent trigeminal artery associated with a saccular aneurysm at its trunk

Computed tomography angiography study of the azygos vein course and termination into superior vena cava: gender and age impact