Elevated end-diastolic ratio of the common carotid artery due to cerebral arteriovenous malformation: Two case reports

Koji Tanaka, MD; Shoji Matsumoto, MD, PhD; Takeshi Yamada, MD, PhD; Daisuke Kondo, MD; Hideo Chihara, MD, PhD; Motohisa Koga, MD; Taketo Hatano, MD, PhD; Tomoya Miyagi, MD, PhD; Ryo Yamasaki, MD, PhD; Jun-ichi Kira, MD, PhD

Radiology Case Reports (Aug 2018)

Elevated end-diastolic ratio of the common carotid artery due to cerebral arteriovenous malformation: Two case reports

Koji Tanaka, MD,
Shoji Matsumoto, MD, PhD,
Takeshi Yamada, MD, PhD,
Daisuke Kondo, MD,
Hideo Chihara, MD, PhD,
Motohisa Koga, MD,
Taketo Hatano, MD, PhD,
Tomoya Miyagi, MD, PhD,
Ryo Yamasaki, MD, PhD,
Jun-ichi Kira, MD, PhD

Affiliations

Koji Tanaka, MD: Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan; Corresponding author.
Shoji Matsumoto, MD, PhD: Department of Neurology, Kokura Memorial Hospital, 3-2-1 Asano, Kokurakita-ku, Kitakyushu, Fukuoka 802-8555, Japan
Takeshi Yamada, MD, PhD: Department of Neurology, Saiseikai Fukuoka General Hospital, 1-3-46 Tenjin, Chuo-ku, Fukuoka 810-0001, Japan
Daisuke Kondo, MD: Department of Neurology, Kokura Memorial Hospital, 3-2-1 Asano, Kokurakita-ku, Kitakyushu, Fukuoka 802-8555, Japan
Hideo Chihara, MD, PhD: Department of Neurosurgery, Kokura Memorial Hospital, 3-2-1 Asano, Kokurakita-ku, Kitakyushu, Fukuoka 802-8555, Japan
Motohisa Koga, MD: Department of Neurosurgery, Saiseikai Fukuoka General Hospital, 1-3-46 Tenjin, Chuo-ku, Fukuoka 810-0001, Japan
Taketo Hatano, MD, PhD: Department of Neurosurgery, Kokura Memorial Hospital, 3-2-1 Asano, Kokurakita-ku, Kitakyushu, Fukuoka 802-8555, Japan
Tomoya Miyagi, MD, PhD: Department of Neurosurgery, Saiseikai Fukuoka General Hospital, 1-3-46 Tenjin, Chuo-ku, Fukuoka 810-0001, Japan
Ryo Yamasaki, MD, PhD: Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
Jun-ichi Kira, MD, PhD: Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan

Journal volume & issue: Vol. 13, no. 4
pp. 917 – 920

Abstract

Read online

An elevated end-diastolic (ED) ratio of the common carotid artery (CCA) is an indicator of occlusive lesions of the distal portion of the internal carotid artery. We report 2 cases of cerebral arteriovenous malformation (AVM) showing an elevated ED ratio of the CCA, which decreased after surgery. Case 1 was a 28-year-old man with chronic recurrent headache with aura, and case 2 was a 29-year-old woman with sudden-onset headache and intracerebral hemorrhage without neurologic abnormality. In both cases, digital subtraction angiography revealed a Spetzler-Martin Grade IV AVM, which was mainly fed by branches of the left middle cerebral artery with venous drainage into superficial and deep cerebral veins. Preoperative carotid ultrasonography showed an elevated CCA ED ratio (1.38 in case 1 and 1.47 in case 2; left > right) without atherosclerotic lesions. Patients’ AVMs were successfully resected. In both cases, the ED ratio was decreased after surgery (to 1.05 in case 1 and 1.20 in case 2). A decrease in vascular resistance on 1 side caused by cerebral AVM can result in an increase in the CCA ED ratio comparable to that of carotid axis occlusion. Keywords: Carotid ultrasonography, Cerebral arteriovenous malformation, End-diastolic ratio

Published in Radiology Case Reports

ISSN: 1930-0433 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Medicine (General): Medical physics. Medical radiology. Nuclear medicine
Website: https://www.sciencedirect.com/journal/radiology-case-reports

About the journal