NEUROIMAGING
Year : 2016  |  Volume : 11  |  Issue : 4  |  Page : 380-381

Kissing carotids: An unusual cause of dysphagia in a healthy child

Shruti Chandak¹, Anirban Mandal², Amitabh Singh^3
1 Department of Radiodiagnosis, Teerthanker Mahaveer Medical College, Moradabad, Uttar Pradesh, India
² Department of Pediatrics, Sitaram Bhartia Institute of Science and Research, New Delhi, India
³ Department of Pediatrics, Chacha Nehru Bal Chikitsalaya, New Delhi, India

Date of Web Publication

3-Feb-2017

Correspondence Address:
Amitabh Singh
Department of Pediatrics, Chacha Nehru Bal Chikitsalaya, New Delhi - 110 031
India

Source of Support: None, Conflict of Interest: None

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DOI: 10.4103/1817-1745.199464

How to cite this article: Chandak S, Mandal A, Singh A. Kissing carotids: An unusual cause of dysphagia in a healthy child. J Pediatr Neurosci 2016;11:380-1

How to cite this URL: Chandak S, Mandal A, Singh A. Kissing carotids: An unusual cause of dysphagia in a healthy child. J Pediatr Neurosci [serial online] 2016 [cited 2023 Jan 30];11:380-1. Available from: https://www.pediatricneurosciences.com/text.asp?2016/11/4/380/199464

A 12-year-old previously healthy girl presented with insidious onset, slowly progressive difficulty in swallowing, which was more with solids. There was no history of pain on deglutition, chest pain, foreign body sensation in throat, change in voice, heartburn, and choking or coughing during swallowing. Her systemic examination was also noncontributory. Examination of the throat revealed a smooth, pulsatile bulge on the posterior wall of oropharynx. Contrast-enhanced computed tomography revealed ectatic bilateral common carotid arteries in the retropharyngeal region near the midline with a minimum distance of 1.0 mm in between them from C4 to C6 vertebral level [Figure 1]a and [Figure 1]b. Bilateral internal jugular veins also appeared slightly medially displaced. Thus, a diagnosis of “kissing carotids” was made.

Figure 1: Axial (a) and coronal (b) contrast-enhanced computed tomography images showing ectatic medially displaced bilateral common carotid arteries in the cervical region at C4 to C6 vertebral level Click here to view

Anatomical variations of the extracranial internal carotid arteries (ICA) occur in 5%–6% of the general population.^[1] The cervical part of the ICA (pars cervicalis) reveals following three major abnormalities in route-tortuosity, kinking, and coiling.^[2] The term “kissing carotid aneurysm” refers to bilateral carotid artery aneurysms which meet in the midline. Depending on the location, this anomaly may lead to different clinical consequences:^[2] transient ischemic attacks, stroke, hormonal dysfunction, cerebral hypoperfusion, sudden death, and prevertebral swelling mimicking fracture.^[3] Most of the cases are incidental intraoperative or radiological findings.^[4]

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.





 

References

1.	Pfeiffer J, Ridder GJ. A clinical classification system for aberrant internal carotid arteries. Laryngoscope 2008;118:1931-6.
2.	Uysal M, Bakirci S, Coskun I, Ari I. Bilateral variation in the course of the internal carotid artery: Case report. Eur J Anat 2007;11:197-200.
3.	Gowdh NS, Gill FJ, Regan LA, Wilkie SW. Kissing carotid arteries: An unusual cause of prevertebral swelling. BMJ Case Rep 2014;2014. pii: Bcr2014206099.
4.	Becker C, Ridder GJ, Pfeiffer J. The clinical impact of aberrant internal carotid arteries in children. Int J Pediatr Otorhinolaryngol 2014;78:1123-7.

Figures

  [Figure 1]

This article has been cited by 1 Carotid Anomalies and Their Implication in ENT Surgery Sudhagar Eswaran, Z. Nufra Senopher, Prasanna Kumar Saravanam Indian Journal of Otolaryngology and Head & Neck Surgery. 2021; [Pubmed] | [DOI] 2 Anterior cervical discectomy and fusion in the setting of kissing carotids: A technical report and literature review Mansour Mathkour, Tyler Scullen, Michael Debakey, Adam Beighley, Basit Jawad, Jonathan Riffle, Hussam Abou-Al-Shaar, R. Shane Tubbs, James Kalyvas Clinical Neurology and Neurosurgery. 2021; 200: 106366 [Pubmed] | [DOI] 3 Craniovertebral junction anomaly with kissing carotids Nitin Kumar, Jaskaran Singh Gosal, Sarbesh Tiwari, Mayank Garg, Suryanarayanan Bhaskar, Deepak Kumar Jha Surgical Neurology International. 2020; 11: 377 [Pubmed] | [DOI]