Jeannin et al., "Association between carotid bulb
diaphragm and ischemic stroke in young Afro-Caribbean patients," Stroke, vol.
Caption: Figure 1: (a) Axial contrast-enhanced CT scan (soft tissue window) shows poorly delineated thickening of the left carotid bulb
Carotid IMT was measured at the far wall of the common carotid artery (CCA) at a 1 cm segment 1 cm proximal to the inferior end of the carotid bulb
. Carotid arterial stiffness was evaluated over the near and far walls of the CCA at the same segment (Figure 1).
Comparison of two techniques of CIMT interrogation: the technique used to measure CIMT in our control group and comparison groups avoided the 2 mm of the CCA nearest to the carotid bulb
. While, in older populations, the carotid bulb
is the region most likely to have focal plaque deposition resulting in dissimilar CIMT measurements to other areas of the CCA, none of the patients included in our study had focal plaque deposition in this area.
Technically, it has been usually measured in CCA, rather than the carotid bulb
or internal carotid artery, because CCA is easily visualized perpendicular to the ultrasound beam and provides more accurate, reproducible, and quantitative measurement (20).
MRI provides details about how soft tissue is affected by the tumor, and it may detect carotid bulb
and jugular vein occlusion.
The US findings in these three patients (with hepatitis) showed focal homogenous echogenic plaque resting on the anterior wall of the common carotid bulb
that measured 5x1.8 mm at its maximum dimension in one of the males.
We only looked at the common CIMT and did not examine the intima-media thicknesses in the carotid bulb
or the internal carotid artery; the evaluation of atherosclerosis in these segments may vary.
The mid and distal portions of the common carotid artery, carotid bulb
, and the proximal portions of the internal and external carotid arteries were systematically examined manually in short-axis and long-axis views.
With the patient in a supine position with slight cervical hyperextension, the CIMT measurements were assessed in a sagittal plane, 1 cm proximal to the carotid bulb
on the posterior wall of a plaque-free region.
Stenosis is most significant at the carotid bifurcation, also known as the carotid bulb
, where the common carotid artery branches into the internal and external carotid arteries.
Other exams which are important in the general evaluation-phase of a carotid bulb
paragangliomas are endocrine study and 123I-MIBG scan.