Uncommon pathology of the Carotid System Flashcards
What pathology is known as the abnormal growth and development of the muscular layer of an artery wall with fibrosis and collagen deposition causing a localized series of stenoses?
Fibromuscular dysplasia
What are the other names for a carotid body tumour?
- Paraganglioma
- Chemodectoma
Where are carotid artery tumours located?
At the carotid bifurcation
What vessel is most commonly affected by tortuosity?
ICA
In the case of a tortuous vessel, where should you document doppler velocities?
Before, in, and beyond the curve/kink
What type of waveform may be seen if a tortuous vessel is producing a stenosis?
Tardus parvus in the case of a distal stenosis
What pathology is known as a separation of layers of an artery by a tear in the intima?
Arterial dissection
In what 3 clinical situation are dissections seen?
- Extension into the CCA from aortic dissection
- Trauma to the ICA
- From underlying disease such as FMD, arteritis, or defects in the vessel wall collagen
What is the hallmark appearance of an ICA dissection?
- Intramural hematoma
- Luminal narrowing or occlusion of true lumen
In a dissection, if blood exits the false lumen via a secondary tear PROXIMAL to the original tear, will flow appear antegrade or retrograde?
Retrograde
In a dissection, if blood exits the false lumen via a secondary tear DISTAL to the original tear, will flow appear antegrade or retrograde?
Antegrade
What is the MOST COMMON cause of stroke in young and middle aged individuals?
Dissection
Patient symptoms with an ICA dissection vs CCA dissection?
- ICA:
- Unilateral pain of head, neck, and face
- Partial Horner syndrome (ptosis: drooping of eyelid), miosis: constriction of the pupil)
- Cerebral or retinal ischemia - CCA: headaches and neck pain
In a dissection, where is the true lumen in relation to the false lumen?
True lumen is anterior to the false lumen
Where in the ICA are most cases of dissection?
Very superior and not identifiable on a carotid scan
What pathology contains abnormal growth of smooth muscle cells and fibrous tissue?
FMD
What is the most common sonographic presentation of FMD?
“String of beads” and dilation
What arteries are typically affected by FMD?
ICA and renal arteries
In what population does FMD usually occur?
Young females
What is the most common symptom of renal FMD?
Hypertension