Bilateral hypoplasia of the internal carotid artery: a focused review

Short title: ICA hypoplasia

  • Milena Trandafilović
Keywords: internal carotid artery, bilateral hypoplasia, anatomy-physiology status, diagnostic preconditions, associated pathology

Abstract


Introduction: The internal carotid artery (ICA) is a paired artery that primarily supplies the anterior two-thirds of the brain, the pituitary gland, the sense of sight, and some other cranial structures.

Aim: The ICA variations or abnormalities were more or less described; especially, bilateral ICA hypoplasia (ICAH) was a very rare description that inspired authors to its evaluation. 

Methods: The definition of ICAH was based on an artery diameter smaller than 3 mm. Human cases of bilateral ICAH were found by using the corresponding keywords in online bases.

Results: Only 64 cases (28 females, 19 males, and 17 cited cases) were found.  Some (ab)normal morphological features such as a narrowing of the ICA beyond a normal initial cervical subpart, the presence of a hypertrophic collateral network, small carotid canals, ICA termination in the ophthalmic artery, an increase of the total flow volume in the vertebral arteries, and a possibility of ICA occlusion and/or cerebral ischemia or hemorrhage at an unusually early age were evidenced. The statistical analysis of cases of known age and gender was performed. A comparison between the main morphological and pathological findings of bilateral hypoplasia and bilateral absence of the ICA has been done. 

 

Conclusion: The literature on the ICAH topic provides confirmative and contradictory examples of suggested bilateral ICAH criteria. Some shapes of cranial hemorrhage and/or aneurysms of the vertebrobasilar system in patients have been proven. Paradoxically, aneurysms occurred more frequently in ICAH than in a similar number of bilateral ICA absence cases.

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Published
2025/11/20
Section
Pregledni rad / Review article