Introduction/Aim. The internal carotid artery (ICA) is a paired artery that primarily supplies the anterior two-thirds of the brain, the pituitary gland, the eye structures, and some other cranial structures. The ICA variations or abnormalities have been more or less described; especially, bilateral ICA hypoplasia (ICAH) was a very rare description that inspired authors to its evaluation. Methods. The definition of ICAH was based on an artery diameter smaller than 3 mm. Human cases of bilateral ICAH were found by using the corresponding keywords in online bases. Results. Only 64 cases (28 females, 19 males, and 17 cited cases) were found. Some (ab)normal morphological features such as a narrowing of the ICA beyond a normal initial cervical subpart, the presence of a hypertrophic collateral network, small carotid canals, ICA termination in the ophthalmic artery, an increase of the total flow volume in the vertebral arteries, and a possibility of ICA occlusion and/or cerebral ischemia or hemorrhage at an unusually early age were evidenced. The statistical analysis of cases of known age and gender was performed. A comparison between the main morphological and pathological findings of bilateral hypoplasia and bilateral absence of the ICA was done. Conclusion. The literature on the ICAH topic provides confirmative and contradictory examples of suggested bilateral ICAH criteria. Some types of cranial hemorrhage and/or aneurysms of the vertebrobasilar system in patients were proven. Paradoxically, aneurysms occurred more frequently in ICAH than in a similar number of cases that described bilateral absence of ICA.
References
1.
Desmond Hawkins T, Scott WC. Bilateral rete carotidis in man. Clinical Radiology. 1967;18(2):163–5.
2.
Chugh C, Agarwal H, Reddi R, Walia B. Bilateral carotid hypoplasia with multiple posterior circulation aneurysms. Neurology India. 2019;67(1):333.
3.
Kato H, Nagata K, Kawamura S. Vascular and metabolic reserve in a case of hypoplasia of bilateral internal carotid arteries] (Abstract. Rinsho Shinkeigaku. 2000;40:1096–100.
4.
Luk YS, Man EMW, Sy ANL. Bilateral hypoplasia of the internal carotid arteries. Singapore Med J. 2010;51:163–5.
5.
Kawai K, Takahashi H, Ikuta F. Bilateral hypoplastic internal carotid arteries with multiple cerebral aneurysms (Abstract. Clin Neuropathol. 1989;8:272–5.
6.
Erdem Y, Yilmaz A, Ergün E. Bilateral internal carotid artery hypoplasia and multiple posterior circulation aneurysms. Importance of 3DCTA for the diagnosis. Turk Neurosurg. 2009;19:168–71.
7.
Guegan Y, Kerdiles Y, Fardoun R, Pecker J. Extra-intracranial anastomosis using a venous graft. Acta Neurochirurgica. 1981;59(3–4):177–85.
8.
Vuia O, Alexianu M, Gabor S. Hypoplasia and obstruction of the circle of Willis in a case of atypical cerebral hemorrhage and its relationship to Nishimoto’s disease. Neurology. 1970;20(4):361–361.
9.
Jones RR, Wetzel N. Bilateral carotid vertebrobasilar rete mirabile. Journal of Neurosurgery. 1970;33(5):581–6.
10.
Zvan A, A F. Une malformation du cercle de Willis [An abnormality of the circle of Willis. Neurochirurgie. 1962;8:345–8.
11.
Zhang ZY, Sato S, Liu L, Xue S, Liu ZJ, Tian ZH, et al. Congenital Hypoplasia of Bilateral Internal Carotid Artery with Migraine-Like Headache with Aura. Chinese Medical Journal. 2015;128(3):421–2.
12.
Bhat DI, Somanna S, Kovoor JM. Bilateral hypoplasia of the internal carotid artery. Indian Journal of Radiology and Imaging. 2011;21(04):257–60.
13.
Akfirat M, Cihangiroglu M, Özdemir H, Topsakal C, Murat A, Yildirim H. Internal Carotid Artery Hypoplasia in Two Cases. Clinical Radiology. 2002;57(10):951–4.
14.
Austin JH, Stears JC. Familial Hypoplasia of Both Internal Carotid Arteries. Archives of Neurology. 1971;24(1):1–10.
15.
Fujikane M, Katayama S, Yokota N. Klinefelter syndrome accompanied by hypoplasia of the bilateral internal carotid arteries--a case report] (Abstract. Rinsho Shinkeigaku. 1994;34:391–5.
16.
Lee JH, Oh CW, Lee SH, Han DH. Aplasia of the internal carotid artery. Acta Neurochirurgica. 2003;145(2):117–25.
17.
Taşar M, Yetişer S, Taşar A, Uğurel Ş, Gönül E, Sağlam M. Congenital absence or hypoplasia of the carotid artery: Radioclinical issues. American Journal of Otolaryngology. 2004;25(5):339–49.
18.
Lath N, Taneja M. Bilateral congenital hypoplasia of the internal carotid arteries. J HK Coll Radiol. 2008;11:129–31.
19.
Morimoto A. Bilateral hypoplasia of the internal carotid artery associated with carotid rete mirabile. Rinsho Hoshasen. 1987;32:178–9.
20.
Georgiadi E, Papavasileiou G, Sfyroeras GS. Bilateral hypoplasia of the internal carotid artery and ectasia of the internal jugular vein. Journal of Vascular Surgery Cases, Innovations and Techniques. 2023;9(4):101252.
21.
Abnormality.
22.
Variation.
23.
Vasović L. BILATERAL ABSENCE OF THE INTERNAL CAROTID ARTERY VERSUS BILATERAL ABSENCE OF THE VERTEBRAL ARTERY. Facta Universitatis, Series: Medicine and Biology. :007.
24.
Vasović L, Trandafilović M, Vlajković S, Radenković G. Congenital absence of the bilateral internal carotid artery: a review of the associated (ab)normalities from a newborn status to the eighth decade of life. Child’s Nervous System. 2018;34(1):35–49.
25.
Jung H, Ahn YB, Lee SK, Park MS. Bilateral hypoplasia of internal carotid arteries associated with intracranial aneurysm: report of two cases. J Korean Neurosurg Soc. 1996;25:211–6.
26.
Rasalkar DD, Chu WCW, Paunipagar BK. Multiple intracranial vascular anomalies in a patient with hypoplasia/aplasia of the internal carotid arteries, Moyamoya collateralisation, and aneurysms of the posterior fossa circulation. J HK Coll Radiol. 2010;12:127–30.
27.
Okuno T, Nishiguchi T, Hayashi S. A case of carotid superior cerebellar artery anastomosis associated with bilateral hypoplasia of the internal carotid artery represented as the rupture of posterior cerebral artery-posterior communicating artery aneurysm. In: Abstract) No Shinkei Geka. 1988. p. 1211–7.
28.
Zhu L, Xu N, Li Y. Monocular central retinal artery occlusion caused by bilateral internal carotid artery hypoplasia complicated with patent foramen ovale: a case report and review of literature. European Journal of Medical Research. 2021;26(1).
29.
Lányi A, Drobný M. Bilateral hypoplasia and occlusion of the internal carotid artery of nonarteriosclerotic origin. Cesk Radiol. 1983;37:82–8.
30.
Lambert P, Gozet G, Roger J. Hypoplasia of both internal carotid arteries. Lille Med. 1973;18:40–2.
31.
Ebner F. Bilateral hypoplasia of the internal carotid artery] (Abstract. Radiologe. 1982;22:400–4.
32.
Guy G, Elouatassi K, Lancien G. Bilateral hypoplasia of the internal carotid arteries. Apropos of an anatomo-clinical case. Sem Hop. 1974;50:809–18.
33.
Ernest C, Hirsch JF, Metzger I. Bilateral hypoplasia of the internal carotid with persistance of an admirable network. Apropos of a case in an adult. Nouv Presse Med. 1973;2:1655–8.
34.
Michel D, Aimard G, Goutelle A. A series of 11 cases of bilateral thrombosis of the internal carotid artery. Discussion about the aspect of bilateral hypoplasia of the internal carotid arteries in 3 cases. J Méd Lyon. 1971;52:5–61.
35.
Arnould G. Angiomatose carotidienne réalisant un réseau admirable. A propos de deux cas. Rev Neurol (Paris. 1967;116:358–66.
36.
Yaguchi M, Yaguchi H, Sugai Y. Bilateral hypoplasia of the internal carotid artery. Neurology and Clinical Neuroscience. 2019;7(4):225–6.
37.
A EK, F A, Azzusi M. Bilateral hypoplasia of the internal carotid arteries associated with aneurysm of the right posterior communicating artery. A propos of a case] (Abstract. Neurochirurgie. 1989;35:23–30.
38.
Danziger J, Bloch S, Hefer AG. Bilateral rete carotidis in man -a case report. S Afr Med J. 1972;46:1487–8.
39.
Chen PY, Liu HY, Lim KE, Lin SK. Internal Carotid Artery Hypoplasia. Journal of Ultrasound in Medicine. 2015;34(10):1839–51.
40.
Caldas MA, Grilo LB, Soares LP, Custódio P da S, Duarte LMV, Soares CEC. Bilateral Internal Carotid Artery Hypoplasia in Asymptomatic Patient. Case Report. ARQUIVOS BRASILEIROS DE CARDIOLOGIA - IMAGEM CARDIOVASCULAR. 2019;32(4).
41.
Briganti F, Maiuri F, Tortora F, Elefante A. Bilateral hypoplasia of the internal carotid arteries with basilar aneurysm. Neuroradiology. 2004;46(10):838–41.
42.
Araki Y, Imai S, Saitoh A. A case of carotid rete mirabile associated with pseudoxanthoma elasticum: a case report. In: Abstract) No to Shinkei. 1986. p. 495–500.
43.
Akdemir Aktaş H, Farımaz M, Fırat A, Göçmen R. Rare congenital anomalies of the internal carotid artery: anatomic and radiologic aspects of three cases and review of the literature. Surgical and Radiologic Anatomy. 2020;42(11):1363–70.
44.
Zink WE, Komotar RJ, Meyers PM. Internal Carotid Aplasia/Hypoplasia and Intracranial Saccular Aneurysms: Series of Three New Cases and Systematic Review of the Literature. Journal of Neuroimaging. 2007;17(2):141–7.
45.
El Kharras A, Zioua T, Kouki S, Lahutte M, Teriitehau C, Baccialone J, et al. NR45 Hypoplasie bilaterale des carotides internes associee a un volumineux anevrisme de la terminaison basilaire par hyperdebit. A propos d’une observation. Journal de Radiologie. 2006;87(10):1496.
46.
Dictionary HMW, Merriam-Webster. 2024;
47.
Oshima H, Katayama Y. Discovery of cerebrovascular moyamoya disease: research during the late 1950s and early 1960s. Child’s Nervous System. 2012;28(4):497–500.
48.
Takeuchi K, Shimizu K. Hypoplasia of bilateral internal carotid artery. In: No To Shinke. 1957. p. 37–43.
49.
Siddiqui AA, Sobani ZA. Bilateral hypoplasia of the internal carotid artery, presenting as a subarachnoid hemorrhage secondary to intracranial aneurysmal formation: a case report. Journal of Medical Case Reports. 2012;6(1).
50.
Kane AG, Dillon WP, Barkovich AJ. Reduced caliber of the internal carotid artery: a normal finding with ipsilateral absence or hypoplasia of the A1 segment. AJNR Am J Neuroradiol. 1996;17:1295–301.
51.
Omarjee L, Fortrat JO, Larralde A, Pabic EL, Kauffenstein G, Laot M, et al. Internal Carotid Artery Hypoplasia: A New Clinical Feature in Pseudoxanthoma Elasticum. Journal of Stroke. 2019;21(1):108–11.
52.
Krejza J, Arkuszewski M, Kasner SE, Weigele J, Ustymowicz A, Hurst RW, et al. Carotid Artery Diameter in Men and Women and the Relation to Body and Neck Size. Stroke. 2006;37(4):1103–5.
53.
Jeanmart L. Study of the Cerebral Vascularization of the Human Fetus By Transumbilical Angiography. Angiology. 1974;25(5):334–49.
54.
Okita R, Maeshima S, Ozaki F, Yamaga H, Moriwaki H. Cerebral aneurysm in a patient with aplasia of the internal carotid arteries. Journal of Neurology. 2001;248(3):227–8.
55.
Watanabe A, Omata T, Koizumi H, Nakano S, Takeuchi N, Kinouchi H. Bony carotid canal hypoplasia in patients with moyamoya disease. Journal of Neurosurgery: Pediatrics. 2010;5(6):591–4.
56.
Volpe A, Elefante A, De Marco A, Manto A, Giugliano V, Ponticiello G, et al. Ipoplasia bilaterale delle arterie carotidi interne associata ad aneurisma intracranico. Rivista di Neuroradiologia. 2003;16(1_suppl):143–4.
57.
Vasseur M, Carsin-Nicol B, Ebran JM, Willoteaux S, Martin L, Lefthériotis G. Carotid Rete Mirabile and Pseudoxanthoma Elasticum: An Accidental Association? European Journal of Vascular and Endovascular Surgery. 2011;42(3):292–4.
58.
Vaghela DU, Jain AS, Jain TP. Bilateral internal carotid artery hypoplasia associated with Down’s syndrome: a case report. Indian J Radiol Imaging. 2002;12:523–5.
59.
Smith KR, Nelson JS, Dooley JM. Bilateral “hypoplasia” of the internal carotid arteries. Neurology. 1968;18(12):1149–1149.
60.
Sánchez-Montaño M, Guerrero-Amador FI, Herrera-Sánchez A. Bilateral hypoplasia of internal carotid arteries: a case report. Ann Radiol México. 2016;15:161–4.
61.
Pacheco-Perea E, Lerma C, Flores-Batres A, León-Guerrero E, Torres-Machorro A. Bilateral hypoplasia of the internal carotid artery. Acta Neurologica Belgica. 2023;123(1):255–7.
62.
Osborn RE, Mojtahedi S, Hay TC, Dewitt JD. Internal carotid artery hypoplasia. Computerized Radiology. 1986;10(6):283–7.
63.
Carels K, Cornelissen SA, Robben D, Coudyzer W, Demaerel P, Wilms G. Smaller caliber of the internal carotid artery in patients with ipsilateral aplasia of the A1 segment of the anterior cerebral artery: a study with CTA. Acta Neurologica Belgica. 2018;118(2):297–302.
64.
Occleshaw JV, Garland P. Bilateral rete carotidis. The British Journal of Radiology. 1969;42(503):851–3.
65.
Kubis N, Zuber M, Méder JF, Mas JL. CT Scan of the Skull Base in Internal Carotid Artery Hypoplasia. Cerebrovascular Diseases. 1996;6(1):40–4.
66.
Kim DS, Kang SG, Yoo DS, Huh PW, Cho KS, Park CK. Ruptured right posterior inferior cerebellar artery aneurysm associated with hypoplasia of the right vertebral artery and both internal carotid arteries. British Journal of Neurosurgery. 2009;23(5):551–3.
67.
Junġ BO, Lee JI, Choi JH. Congenital hypoplasia of the bilateral internal carotid artery - a case report. J Korean Neurosurg Soc. 2002;31:282–4.
68.
Herwadkar A. A Case of Carotid Rete Mirabile Associated with Basilar Tip Aneurysm. Interventional Neuroradiology. 2006;12(2):161–4.
69.
Gupta B, Yadav R, Singhal M, Kadam N, Gehlot KB, Singh R. A rare case report of bilateral internal carotid artery hypoplasia in postpartum female: Clinical spectrum and role of various modalities in diagnosis. Brain Circulation. 2016;2(2):99–103.
70.
GALLIGIONI F, ANDRIOLI GC, MARIN G, BRIANI S, IRACI G. HYPOPLASIA OF THE INTERNAL CAROTID ARTERY ASSOCIATED WITH CEREBRAL PSEUDOANGIOMATOSIS. American Journal of Roentgenology. 1971;112(2):251–62.
The statements, opinions and data contained in the journal are solely those of the individual authors and contributors and not of the publisher and the editor(s). We stay neutral with regard to jurisdictional claims in published maps and institutional affiliations.
,
