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Case No. 716
2025-03-01~2025-03-31
출제자 : 이지영
Hit : 582
| Period | 2025-03-01~2025-03-31 |
|---|---|
| Diagnosis | Aberrant ICA and Persistent stapedial artery |
| Gender |
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| Age | 36 |
| Clinical information | F/36 c/c: rt. otalgia for 4 days |
| Discussion | -Congenital vascular anomaly resulting from regression of cervical ICA during embryogenesis -Clinical presentation Typically asymptomatic Pulsatile tinnitus and conductive hearing loss Discovered incidentally on otoscopic examination, imaging, or surgery -Biopsy can result in stroke or fatal hemorrhage -No treatment is best treatment -Anatomical course Crosses middle ear cavity from posterior to anterior Hugs cochlear promontory Joins posterolateral margin of horizontal petrous ICA -CT Tubular lesion crossing the middle ear cavity from posterior to anterior Well-delineated soft tissue density lying on the cochlear promontory Deficient bony plate along the tympanic segment of ICA Absence of the vertical segment of the carotid canal Enlargement of the inferior tympanic canaliculus -Angiography More posterolateral course than normal ICA Distinct angulation resembling "7" "pinched" appearance Embryonic stapedial artery that persists postnatally May be seen in association with aberrant ICA Prevalence 0.02-0.5% Mostly discovered incidentally at imaging or surgery Anatomical Course Arises from petrous segment of ICA or aberrant ICA Passes through the stapes footplate Extends superiorly to supply the middle meningeal artery (MMA) intracranially -imaging Enlarged tympanic segment of the facial nerve Absent foramen spinosum on ipsilateral side (MMA arising from PSA not ECA) Vessel passing through the obturator foramen of stapes |
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