Low bifurcation of the common carotid arteries: an anatomical and radiological study

The common carotid artery (CCA) usually bifurcates at the level of the upper border of the thyroid cartilage (C3–4 cervical vertebrae) or the body of the hyoid bone (C3). Despite the fact that bifurcation can occur at any level in the neck, low level bifurcation occurs far less frequently than at higher levels. The CCA is close to many vital structures in the neck, including the trachea, oesophagus, inferior thyroid and vertebral arteries, and recurrent laryngeal nerves. Injury to these structures might be experienced during carotid endarterectomy or in neurosurgical approaches to the anterior aspect of the neck, as in anterior discectomy of the cervical vertebrae. This case demonstrates the level of bifurcation of the CCA and its importance in neck surgery.