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首页> 外文期刊>The Internet Journal of Neurology >Contralateral External Carotid Artery as Collateral to Internal Carotid Artery in a Patient with Common Carotid Artery Occlusion
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Contralateral External Carotid Artery as Collateral to Internal Carotid Artery in a Patient with Common Carotid Artery Occlusion

机译：对侧颈外动脉作为颈内动脉常见闭塞患者的颈内动脉侧支

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Common carotid artery (CCA) occlusion is sometimes associated with collateral flow through carotid bulb that preserves patency of internal carotid artery (ICA). Usually ipsilateral external carotid artery (ECA) anastomotic branches supply the ICA. But in this case, we found the contralateral ECA role in collateralization of the ipsilateral ICA to CCA occlusion using color carotid duplex. Introduction Occlusion of the common carotid artery (CCA) is generally associated with occlusion of the ipsilateral internal carotid artery (ICA) and external carotid artery (ECA). Sometimes, however, collateral circulation to the ECA may preserve patency of the ICA via retrograde perfusion through the bulb (1, 2, 3). This collateral flow can be maintained through ECA anastomotic branches such as superior and inferior thyroidal arteries, deep cervical artery, descending branch of occipital artery (4), superior and inferior labial arteries (5) or an aberrant ICA branch (6). There is no patient report of natural connection of contralateral ECA to ipsilateral ICA as collateral in CCA occlusion patient to restore ICA flow. But this anastomosis surgically can be induced in some patients with CCA occlusion (7). This external carotid to external carotid crossover anastomosis may have application in the management of squamous cell carcinoma involving the common carotid or in the treatment of carotid artery blowout (8).These patients may suffer ongoing transient ischemic attacks and risk for stroke (1). Most authors agree to say that color flow duplex imaging has now become the hallmark to detect a patent ICA in spite of a CCA occlusion (2). Recognition of this pathologic variant may allow for effective surgical intervention (1). Such situation should not be ignored since bypass surgery can easily allow for effective restoration of flow (2). Case Report A 60-year-old, white man presented with Broca aphasia and right central hemifacial weakness. He did not history of hypertension, diabetes mellitus, smoking, or transient ischemic attack. Physical examination showed only absent carotid pulsation in left side of his neck. First day brain CT scan was normal. Subsequent brain CT obtained on 5 th day of admission demonstrated a hypodense lesion in left paraventricular area. Carotid duplex revealed the absence of the blood flow in left CCA .The blood flow in the left ECA was reversed and fed the left ICA (fig.1).
机译：颈总动脉（CCA）闭塞有时与通过颈动脉的侧支流相关联，从而保持了颈内动脉（ICA）的通畅性。通常，同侧颈外动脉（ECA）吻合分支为ICA供血。但是在这种情况下，我们发现对侧ECA在使用彩色颈动脉双工将同侧ICA抵押到CCA闭塞方面发挥了作用。简介颈总动脉（CCA）的闭塞通常与同侧颈内动脉（ICA）和颈外动脉（ECA）的闭合有关。但是，有时通过ECA的侧支循环逆行灌注可能会保持ICA的通畅（1、2、3）。可以通过ECA吻合分支（如甲状腺上和下甲状腺动脉，颈深动脉，枕动脉降支（4），上唇和下唇动脉（5）或ICA异常分支（6））维持这种侧支血流。没有患者报道对侧ECA与同侧ICA作为CCA闭塞患者的侧支可恢复ICA流量的自然联系。但是在某些CCA闭塞患者中，可以通过手术诱发这种吻合（7）。这种外部颈动脉至外部颈动脉交叉吻合术可能适用于涉及普通颈动脉的鳞状细胞癌的治疗或用于治疗颈动脉爆裂的患者（8），这些患者可能会遭受持续的短暂性脑缺血发作和中风的风险（1）。大多数作者同意说，尽管有CCA闭塞，但彩色流双工成像现已成为检测ICA专利的标志（2）。对这种病理学变异的认识可能允许有效的手术干预（1）。这种情况不容忽视，因为搭桥手术可轻松实现血流的有效恢复（2）。病例报告一名60岁的白人男子出现Broca失语症和右侧中央半面肌无力。他没有高血压，糖尿病，吸烟或短暂性脑缺血发作的病史。体格检查仅在颈部左侧没有颈动脉搏动。首日脑部CT扫描正常。入院后第5天获得的随后脑部CT显示左室旁区域有低密度病变。颈双工显示左CCA中无血流。左ECA中的血流逆转并向左ICA供血（图1）。

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