Illustrated Encyclopedia of Human Anatomic Variation: Opus II: Cardiovascular System: Arteries: Head, Neck, and Thorax
Ronald A. Bergman, PhD
Adel K. Afifi, MD, MS
Ryosuke Miyauchi, MD
Peer Review Status: Internally Peer Reviewed
The left common carotid varies more than the right, arising either from the brachiocephalic or from a common stem with the right common carotid. In those cases where the right subclavian is a separate branch of the aorta, the two carotids most frequently arise by a common trunk.
The right common carotid, when arising from the aorta, on occasion, runs behind the trachea or the esophagus to the right side of the neck. The origin of the right common carotid artery may be above or below the usual point, depending on whether the brachiocephalic bifurcates higher or lower than usual. A low bifurcation of the brachiocephalic is somewhat more common. The common carotid artery sometimes follows a very tortuous course, forming one or more distinct loops in the neck.
The common carotids may bifurcate higher or lower than usual; a high bifurcation is more common. The bifurcation can occur as high as the hyoid bone (Quain, 5/295; Poynter, 3/400) or even the styloid process, or as low as the cricoid cartilage (Quain, 10/295; Poynter, 18/400) or within 3.7 cm of its origin. The artery may not bifurcate but provide branches usually derived from the external carotid as it ascends in the neck. A common carotid artery may be absent, the external and internal carotids arising directly from the arch of the aorta or from the termination of innominate artery.
As a very rare occurence, the carotid my ascend in the neck without dividing into the two usual branches; either the external or internal carotid being absent.
The common carotid may provide one or more of the branches usually derived from the external carotid. Examples are: superior thyroid, thyroidea ima, and cases have been reported in which a vertebral, inferior thyroid, or ascending laryngeal is a branch of the common carotid.
The vagus nerve may run in front of the common carotid artery instead of behind it.
Collateral circulation after ligature of a common carotid is maintained by the following anastomoses; blood is conveyed to the cerebral and ophthalmic branches of the internal carotid from the vertebral arteries and the internal carotid from the opposite side, by means of the free communication existing between these vessels and the circle of Willis. The branches of the external carotid receive blood from the subclavian artery through the anastomoses of the superior and inferior thyroid arteries, and of the occipital with the ascending cervical, vertebral, and deep cervical arteries, and from the external carotid of the opposite side through the anastomoses of the two superior thyroid, lingual, facial, superficial temporal, and occipital arteries; and the ophthalmic with the angular. The anastomosis between the deep cervical branch of the costocervical trunk (superior intercostal) and the descending branch of the occipital is important; it is located deep at the back of the neck between semispinalis capitis and cervicis muscles.
Common carotid arteries may give rise to an esophageal artery.
Image 72, Image 287Absence of:
Image 422, Image 436
Image 394, See Image 436
Anson, B.J., Ed. (1966) Morris' Human Anatomy, 12th ed. The Blakiston Division, McGraw-Hill Book Company, New York.
Bergman, R.A., Thompson, S.A., Afifi, A.K. and F.A. Saadeh. (1988) Compendium of Human Anatomic Variation: Catalog, Atlas and World Literature. Urban & Schwarzenberg, Baltimore and Munich.
Boyd, J.D. (1933-34) Absence of the right common carotid artery. J. Anat. 68:551-557.
Campbell, R.L. and M.L. Dyken (1961) Four cases of carotid-basilar anastomosis associated with central nervous system disfunction. J. Neurol.
Cavasse,-. (1856) Anomalies artérielles. Bull. de la Soc. Anatomique de Paris. 31:72-73.
Cavasse, -. (1856) Deux anomalies artérielles, carotids et inferieur diaphragmatiques. Bulletins et Mem. de la Société Anatomique de Paris XXXI(3):71-73.
Deaver, J.B. (1888) Anomalies of the carotid artery. University Medical Magazine, Univ. of Pennsylvania. 1:360-361.
Davies-Colley, N., Taylor, F. and B.N. Dalton (1873) Left carotid arising from the innominate. Guy's Hosp. Reports, London 18:389-401.
Dubrueil, J.M. (1847) Des Anomalies Arterielles. Bailliere, Paris.
Dunn, L.H., Washburn, J.W. and J.H.Targett. (1888) Abnormalities observed in the dissecting room of Guy's hospital. Guy's Hosp. Reports, London 47:299-316.
Faller, A. (1946) Zur Kenntnis der Gefässverhältnisse der Carotisteilungsstalle. Schweiz. Med. Wochenschrift 76:1156-1158.
Fetterolf, G. (1908) Variations in the arteries of the human body. University of Pennsylvania Medical Bulletin 21:323-329.
Henle, J. (1868) Handbuch der Systematischen Anatomie des Menschen. Von Friedrich Vieweg und Sohn, Braunschweig.
Horrocks, P., Hale-White, W. and W.A. Lane. (1884) An account of the abnormalities observed in the dissecting room, 1882-83. Guy's Hospital Reports. 42:39-48.
Huber, G.C., Ed. (1930) Piersol's Human Anatomy, 9th ed. L.B. Lippincott C., Philadelphia.
Huber, G. and U. Piepgras. (1976) Origin of the left vertebral artery from the left external carotid artery. Fortschritte Röntgenstrahlen. 125(l):63-66.
Kantor, H. (1905) Tiefe Teilung der arteria carotis communis. Anat. Anz. 26:492-496.
Keess, J. (1853) Arterial varieties. Madras Journal of Medical Science 3:183-186.
Kosinski, J. (1867) Absence de carotide primitive droite. Division du tronc brachio-céphalique en sous-clavière, carotid externe et carotid interne. Bulls. et Mems. de la Soc. Anatomique de Paris. 42:722-724.
Kukwa, A. and A. Zbrodowski. (1966) A rare case of origin of the superior thyroid from the left common carotid artery. Folia Morphol., Warsaw 25:600-602.
Kunishio, K., Yamamoto, Y., Sunami, N. and S. Asari. (1987) Agenesis of the left internal carotid artery, common carotid artery, and main trunk of the external carotid artery associated with multiple cerebral aneurysms. Surg. Neurol. 27:177-181.
Latarjet, A. (1948) Testut's Traite D'Anatomie Humaine, 9th ed. G. Doin & Cie., Paris.
Lie, T.A. (1968) Congenital anomalies of the carotid arteries. An angiographic study and a review of the literature. In Excerpta medica, Amsterdam.; pp31-51.
McAfee, D.K., Anson, B.J., and J.J. McDonald. (1953) Variation in the point of bifurcation of the common carotid artery. Q. Bull. Northwestern University Medical School 27:226-229.
Morimoto, T., Nitta, K., Kazekawa, K. and K. Hashizume. (1990) The anomaly of a nonbifurcating cervical carotid artery. J. Neurosurgery. 72:130-132.
Ozenne, -. (1883) Anomalie d'origine de la carotide droite et de l'artère sous-clavière du même côté. Bull. Soc. Anatomique Paris 58:108.
Padget, D.H. (1948) The development of cranial arteries in the human embryo. Contrib. Embryol. Carnegie Institute 32:205-261.
Parmentier, -. (1850) Anomalies artérielles; common carotide. Bull. et Mém. de la Soc. Anatomique de Paris 1850:74.
Parmentier, -. (1850) Anomalie de la carotid et de l'artère humérale. Bulletins et Mem. de la Société Anatomique de Paris XXV(3):74-75.
Poynter, C.W.M. (1922) Congenital anomalies of the arteries and veins of the human body with bibliography. The University Studies of the University of Nebraska, Lincoln 22:1-106.
Roberts, L.K. and B. Gerald. (1978) Absence of both common carotid arteries. Am. J. Radiol. (AJR) 130:981-982.
Schaefer, E.A., Symington, J. and T.H. Bryce., Eds. (1915) Quain's Anatomy, 11th ed. Longmans, Green and Co., London,
Schreiber, H. (1941) Seltene Varietät der Art. carotis. Anat. Anz. 91:269-271.
Schwalbe, G. (1878) Ueber Wachsthumsverschiebungen und ihr Einfluss auf die Gestaltung des Arteriensystems. Jenaische Zeitschrift für Medicin und Naturwissenschaft 12:267-301.
Schwalbe, G. und W. Pfitzner. (1894) Varietäten-Statistik und Anthropologie. Morphologische Arbeiten 3:459-409.
Suarez de Lezo, J., Montero Argudo, J., Pasalodos Pita, J., Fernandez Garcia, J.C., Arizon del Prado, J.M., Concha Ruiz, M. and F. Valles Belsue. (1980) Vascular ring caused by an abnormal right subclavian artery and common carotid trunk. Rev. Esp. Cardiol. 33(5):553-557.
Swigart, LaV.L., Siekert, R.G., Hambley, W.C. and B.J. Anson. (1950) The esophageal arteries. An anatomic study of 150 specimens. Surg., Gynecol. Obstet. 90:234-243.
Wurtz, K.G. and N.B. Powell. (1948) Two unusual vascular and cardiac anomalies. I. Vascular ring of the esophagus with patent ductus arteriosus. Origin of the left subclavian and carotid arteries. II. Persistent atrioventricular communis and aortic dextroposition with mongolism. J. Pediatr. 33:722-733.
Wyeth, J.A. (1878) Essay upon the surgical anatomy and history of the common, external and internal carotid arteries. Trans. Am. Med. Assoc. 29:1-139.
Section Top | Title Page
Please send us comments by filling out our Comment Form.
All contents copyright © 1995-2014 the Author(s) and Michael P. D'Alessandro, M.D. All rights reserved.
"Anatomy Atlases", the Anatomy Atlases logo, and "A digital library of anatomy information" are all Trademarks of Michael P. D'Alessandro, M.D.
Anatomy Atlases is funded in whole by Michael P. D'Alessandro, M.D. Advertising is not accepted.
Your personal information remains confidential and is not sold, leased, or given to any third party be they reliable or not.
The information contained in Anatomy Atlases is not a substitute for the medical care and advice of your physician. There may be variations in treatment that your physician may recommend based on individual facts and circumstances.
This site complies with the HONcode standard for trustworthy health information: