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

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


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 Publication3-Feb-2017

Correspondence Address:
Amitabh Singh
Department of Pediatrics, Chacha Nehru Bal Chikitsalaya, New Delhi - 110 031
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1817-1745.199464

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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 2017 Sep 22];11:380-1. Available from: http://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

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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]

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   References Top

1.
Pfeiffer J, Ridder GJ. A clinical classification system for aberrant internal carotid arteries. Laryngoscope 2008;118:1931-6.  Back to cited text no. 1
    
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.  Back to cited text no. 2
    
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.  Back to cited text no. 3
    
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.  Back to cited text no. 4
    


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