[Bilateral hypoplasia of the internal carotid arteries associated with aneurysm of the right posterior communicating artery. Apropos of a case].
The authors report a case of bilateral hypoplasia of the internal carotid arteries associated with aneurysm of the right posterior communicating artery in a 17 year old female patient. This anomaly was discovered following a meningeal haemorrhage, which recurred 18 months later, causing the patient's death. Surgical operation was refused by the patient and her family. Bilateral hypoplasia of the internal carotid arteries is a rare congenital malformation (16 cases have been reported in the literature, our case constitutes the 17th). It is distinguished from aplasia by the presence of a patent but very reduced vascular lumen, while aplasia is associated with vestiges of non-patent vessels. The mechanism of development of such a malformation is unclear: some authors have suggested secondary regression of the internal carotid artery following a phase of normal development, while others consider it to represent arrest of the development of the internal carotid artery, at a given moment in time. The frequency of associated aneurysm would be due to the haemodynamic disruption induced by the malformation, especially as parietal defects are more frequent in a malformed vasculature. Bilateral hypoplasia of the internal carotid arteries may be compatible with normal life for an indefinite period of time due to the development of a large number of collateral vessels. However, the new vasculature is threatened by rupture with meningeal haemorrhage and by acute ischaemia, which would probably involve another aetiological factor.
el Khamlichi
A
A
Service de Neurochirurgie, de l'Hôpital des Spécialités Oto-Neuro-Ophtalmologiques, C.H.U. de Rabat, Maroc.
Amrani
F
F
el Azzusi
M
M
el Oufir
M
M
Khamlichi
A M
AM
D000293:Adolescent; D000328:Adult; D002343:Carotid Artery, Internal / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000196:embryology; D002536:Cerebral Arteries; D002648:Child; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications* / Q000000981:diagnostic imaging; D008875:Middle Aged; D011859:Radiography
Hypoplasie bilatérale des carotides internes associée à un anévrysme de la communicante postérieure droite. A propos d'une observation.