Carotid Stenosis measurement.

NASCET North American Symptomatic Carotid Endarterectomy Trial

Measures the smallest lumen And compares to Maximal diameter where are the artery is straight
and parallel To the internal Maxillary.

Express residual lumen as A/B x 100/1 Where A is the residual lumen and B is the nomal internal
carotid.

A third phase MIP can help to find occlusions.

The carotid Bifurcation is at C4.

In The external carotid artery has the following branches:

Superior thyroid, Ascending pharyngeal, Lingual, Facial, Occipital, Posterior auricular, Superficial
temporal, Internal maxillary.

The last bifurcation of the external carotid artery into the superficial temporal and internal maxillary
occurs in the parotid gland.

The internal maxillary has three branches including the middle meningeal artery.

These branches are as follows:

1. Mandibular part: This gives off in the middle meningeal artery,Which travels through the
foramen spinosum.

2. Pterygoid part: This gives branches to the muscles of mastication.

3. Pterygopalatine segment: This gives off the sphenopalatine artery which is the terminal
branch.

A persistent trigeminal artery arises from the posterior cavernous carotid. It joins the basilar. In this
arrangement,the patient will typically have no Posterior communicating artery P-comm .

There are other persistent arteries: for example, Persistent trigeminal artery arising from the
posterior cavernous carotid And joining the basilar artery.These typically have no P-comm.

Persistent hypoglossal(12) Otic (7/8) But trigeminal is the most common.

The Ophthalmic artery terminates as the central retinal artery.

Do not mistake the posterior communicating infundibulum for

an aneurysm.