先天性颈内动脉发育不良患者的临床与影像学特点分析

Clinical and radiological features of patients with hypoplasia of the internal carotid artery

目的分析先天性颈内动脉发育不良患者的临床与影像学特点。方法北京市大兴区人民医院神经内科自2010年1月至2021年12月共收治4例先天性颈内动脉发育不良(含3例先天性颈内动脉缺如)患者,回顾性分析患者的临床资料和影像学特点。结果4例患者中男性2例,女性2例,年龄范围31~73岁。2例患者临床表现为头晕,1例患者表现为肢体无力,1例患者无症状。3例颈内动脉缺如患者DSA结果中颈内动脉不显影,CT骨窗显示颈内动脉管缺如;1例颈内动脉发育不良患者DSA结果中呈纤细显影。1例患者合并前交通动脉瘤及左侧颈内动脉瘤,1例患者左侧椎动脉增粗。患者的侧支循环代偿分型:A型3例,C型1例。结论先天性颈内动脉发育不良患者临床可无症状,颈内动脉缺如患者可表现为缺血症状;患者可合并动脉瘤、血管增粗等血管发育异常。

Objective To analyze the clinical and radiological features of patients with hypoplasia of the internal carotid artery.Methods Four patients with hypoplasia of the internal carotid artery(including 3 patients with congenital absence of the internal carotid artery),admitted to our hospital from January 2010 to December 2021,were chosen in our study.The clinical data and imaging features of these patients were retrospectively analyzed.Results The age of these patients ranged from 31 to 73 years,and two patients were female.Clinically,2 patients presented with dizziness,1 patient presented with limb weakness,and 1 patient was asymptomatic.In 3 patients with congenital absence of the internal carotid artery,DSA results showed that the internal carotid artery was not developed,and CT bone window showed that the internal carotid artery canal was absent;1 patient with hypoplasia of the internal carotid artery showed thin imaging in DSA results.One patient was combined with anterior communicating artery aneurysm and left internal carotid artery aneurysm.One patient was with vertebral arterial dolichoectasia.The collateral circulation compensation:type A was noted in 3 patients and type C was noted in 1 patient.Conclusion The patients with hypoplasia of the internal carotid artery are usually asymptomatic,and patients with congenital absence of the internal carotid artery can have ischemic symptom;these patients can be complicated with vascular abnormalities such as aneurysm and vascular thickening.