Carotid Anatomy/Invasion Criteria HN37-41

Question 1

Carotid Invasion Criteria (2)

Answer 1

1) Effacement >25% of circumference

2) Tumour encases >75% circumference

Question 2

MRI criteria for inability to peel off tumour from carotid artery

Answer 2

270 degree involvement

Question 3

Brain Complications after Common Carotid Occlusion:

a) abrupt ligation
b) gradual under 7 days
c) gradual over 7 days

ICA Occlusion rate of complication?LOOK UP DONT KNOW

Answer 3

a) abrupt ligation = 40%
b) gradual under 7 days = 30%
c) gradual over 7 days = 5%

Question 4

4 Carotid Occlusion Tests

Answer 4

1) 4 vessel angiography (carotid + vertebrals)
2) Balloon Occlusion Tests
3) SPECT (nuclear med imaging) + Tc-99m HMPAO
4) SPECT + Xenon -133 inhaled gas

Question 5

Preoperative Intervention prior to Simple Carotid Ligation

Answer 5

Place permanent balloons/coils proximal to ophthalmic artery.

• 2 weeks prior to surgery
• monitor for 72hrs after occlusion

Question 6

7 Segments of the ICA

Answer 6

o	C1 - Cervical 
o	C2 - Petrous 
o	C3 - Lacerum
o	C4 - Cavernous 
o	C5 - Clinoid
o	C6 - Ophthalmic
o	C7 - Communicating