Tortuous neck vessels in Hypertension

Aortic arch angiogram Left anterior oblique view illustrates marked elongation and tortuosity of the major neck vessels that arise from the aortic arch namely innomiate, Left CCA and Left Subclavian. These changes are often seen in pts with long-standing hypertension.


Such cases are reported with a subcutaneous pulsatile swelling in neck supra clavicular region and subsequent CT or magnetic resonance imaging (MRI) reveals evanescent course of otherwise normal artery, the tortuous artery in most of the cases reported is innominate forming a pulsatile swelling in right supra clavicular region.
Cause of this tortuousity or kinking is unclear but often accompany hypertension, obesity in elderly females. Arteriosclerotic changes due to hyperlipidemia, decreased elasticity of vessel wall due to ageing is also suggested.