High-riding brachiocephalic artery

Case contributed by Andrea Molinari
Diagnosis certain

Presentation

CT angiography prescribed for aortic bulb dilation. The patient reported a pulsatile and palpable lump in the anterolateral right neck region.

Patient Data

Age: 70 years
Gender: Female

CT angiography showed that the brachiocephalic artery ascended into the neck, lying anterior to the trachea and dividing into right common carotid artery and right subclavian artery just below the right lobe of the thyroid gland.

Case Discussion

High-riding brachiocephalic artery is a rare vascular variant in which the brachiocephalic artery ascends and bifurcates much more superiorly than normally. 

It is usually noted as an incidental finding. It is mandatory to report it because it is associated with hemorrhagic complications during surgical procedures in the neck, such as tracheostomy 1.

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