Dissertation submitted to the Faculty of Health Sciences of the University of the Witwatersrand, Johannesburg in fulfilment of the requirement for the degree of Master of Science in Medicine. Johannesburg 23 April 2015 / Knowledge of the anatomical variation in the carotid arterial system is important in understanding the pathogenesis and surgical treatment of atheroma. Thus, this study investigated the anatomical variation of the carotid arterial system and the frequency of atheroma within a South African population. The carotid arterial systems were exposed bilaterally in 77 adult cadavers using standard dissection. The level of the carotid bifurcation, position and curving of the carotid arteries and frequency of common trunks and atheroma were recorded. In addition, the lengths and diameters of the carotid arteries and branches as well as the bifurcation angle were measured. Data was analyzed using descriptive and inferential statistics. The carotid bifurcation most commonly occurred at the C3-C4 intervertebral disc. White males had longer common carotid arteries than white females. The lengths of the internal and external carotid arteries were longer in white males compared to black males. There was a higher frequency of curving of the carotid arteries in white females compared to white males. The thyro-lingual trunk was the most common trunk within the sample. The internal carotid artery was postero-lateral to the external carotid artery within most individuals. In addition, atheroma was observed at the carotid bifurcation in all individuals. The level of the carotid bifurcation, positioning, length and diameter of the carotid arteries in the South African population are similar to descriptions in anatomical texts. The differences found within the study may be attributable to the age of the sample as well as the embryological development of the carotid arteries within the South African population. These variations may influence blood flow within the carotid arteries. Thus, knowledge of these variations may aid in understanding the aetiology and the surgical treatment of atheroma.

Thesis (Ph.D.)--Case Western Reserve University, 2009 / Title from PDF (viewed on 19 August 2009) Department of Biomedical Engineering Includes abstract Includes bibliographical references Available online via the OhioLINK ETD Center

A carotid atherosclerotic plaque represents a nidus of inflammation mere centimetres below the blood-brain barrier. This inflammation, along with associated regions of microcalcification, are histopathological features of atheroma at risk of rupture (so-called “vulnerable plaques”) that trigger thromboembolic stroke. While conventional clinical imaging simply measures the degree of vessel stenosis, it is a crude measure that reveals little of the metabolic processes affecting plaque vulnerability. Our research demonstrates the utility of positron emission tomography (PET) using 18F-fluorodeoxyglucose (FDG) and 18F-sodium fluoride (NaF), measuring inflammation and microcalcification respectively, to identify culprit carotid atheroma in vivo, and establish how these processes influence plaque vulnerability. Furthermore, for stroke care it is the downstream thromboembolic effects upon the brain that are key. While proinflammatory conditions may increase the risk of stroke, the relationship between atheroma inflammation and the peri-infarct inflammatory response following a stroke remains poorly defined. Our work demonstrates how inflammatory activity in symptomatic carotid atheroma, measured using PET, influences both chronic small vessel disease and the evolution of lesion volume in the post-stroke period. Using metabolic imaging we can both identify vulnerable atheroma in vivo and demonstrate how these processes affect infarct evolution. We show that whilst inflammation is a generalised process, microcalcification is a focal process that may represent a point of maximum vulnerability. These results also reveal the complexity of the atheroma-brain interaction that may simultaneously trigger events while also influencing stroke evolution in the early recovery period. This has important implications for understanding pathophysiology of both atherosclerosis and stroke evolution, advancing drug-discovery, and potential clinical applications to minimise the impact from this devastating disease.

No description available.

published_or_final_version / Anatomy / Master / Master of Medical Sciences

No description available.

Thesis (Ph. D.)--University of Washington, 1996. / Includes bibliographical references (leaves [97]-104).

Thesis (Ph. D.)--University of Hong Kong, 2007. / Title proper from title frame. Also available in printed format.

No description available.

Thesis (Ph. D.)--University of Washington, 2001. / Vita. Includes bibliographical references (leaves 105-114).