Surgical Treatment of Extracranial Internal Carotid Malformations
Extracranial internal carotid malformations (EICM) are usually congenital, but are often worsened, and sometimes caused, by arteriosclerotic lesions. EICM may be responsible for cerebrovascular insufficiency by embolic or hemodynamic mechanisms. In the former case, they produce changes in blood flow with turbulence and vortexes that are the causes of embolism formation as a result of platelet aggregation. In the latter case, there are hemodynamic alterations from temporary occlusion of the vessel during head movements or from hypotensive attacks . Obviously, a malformed vessel is more likely to cause problems of cerebrovascular insufficiency when associated with anomalies of other epiaortic vessels and/or the circle of Willis, or with stenosing arteriosclerotic alterations of other epiaortic or cerebral vessels. While the incidence of cerebrovascular insufficiency from atheromatic alterations of the epiaortic vessels is greatest in people age 50–60 years, in EICM the most frequently involved age group is 30–50 .
KeywordsInternal Carotid Artery Internal Carotid Atheromatic Plaque Fibromuscular Dysplasia Selective Angiography
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