Introduction

Carotid web is a radiographic entity located in the posterior aspect of the origin of the internal carotid arteries, considered to be a pathologic equivalent to intimal fibromuscular dysplasia, and has been implicated in acute ischemic strokes. The mechanism underlying its development is unknown and it remains unclear if this lesion is congenital or acquired. The aim of our study was to determine the frequency of carotid webs in a pediatric population with acute ischemic stroke (AIS).

Methods

A retrospective review of neck CTA, MRA, or DSA images in a pediatric population with acute ischemic stroke was performed to determine the occurrence of carotid webs. Two fellowship-trained neurointerventionists performed independent vascular imaging review.

Results

We identified forty-seven cases of childhood acute ischemic stroke (55% male; median age, 9 years). Congenital heart disease, sickle cell disease, infection, and recent head/neck trauma were the most common risk factors. Eight of the ischemic stroke cases were located in multiple vascular territories. Neck arterial imaging was undertaken in twenty-four patients. No carotid webs were detected in the studied pediatric stroke population. (The correlation coefficient for the determination of webs was Kappa = 1.00; p < 0.001).

Conclusion

This study failed to find evidence that carotid webs are congenital. More studies are needed for a better understanding of carotid web origin, natural evolution, and the potential implications for treatment.

中文翻译：

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小儿急性缺血性卒中的颈动脉网

介绍

颈动脉网是位于颈内动脉起点后方的放射照相实体，被认为是与内膜纤维肌增生异常等效的病理学，并与急性缺血性卒中有关。其发展的机制尚不清楚，尚不清楚该病变是先天性还是后天性。我们研究的目的是确定患有急性缺血性中风（AIS）的儿童人群中颈动脉网的频率。

方法

回顾性分析急性缺血性卒中患儿的颈部CTA，MRA或DSA图像，以确定颈动脉网的发生。两名接受研究金培训的神经干预专家进行了独立的血管成像检查。

结果

我们确定了47例儿童急性缺血性中风（男性55％；中位年龄9岁）。先天性心脏病，镰状细胞病，感染和最近的头/颈外伤是最常见的危险因素。缺血性中风病例中有八例位于多个血管区域。在24位患者中进行了颈部动脉成像。在所研究的小儿卒中人群中未检测到颈动脉网。（用于测定纤维网的相关系数为Kappa = 1.00；p  <0.001）。

结论

这项研究未能找到颈动脉网是先天性的证据。需要更多的研究以更好地了解颈动脉网的起源，自然进化以及对治疗的潜在影响。