[Observation of sleep disorders in patients with kinking of carotid artery].

Carotid artery redundancy with kinking and coiling can be the cause for acute, ischaemic transitory or even permanent, brain damage and cerebrovascular symptoms. The cerebral ischaemia typically associated to kinking of carotid artery is positional and can be provoked by some (extreme) movenets of the head. The awake patient is coscious of those typical head positions, and capable to avoid them. Prolonged uncontrolled turning of the head during sleep has been reported to cause a stroke in sleep or unpleasant phenomena during sleep. The parasomnias and central sleep apnea syndrome caused by ischaemia on the basis of haemodynamically significant reduction of blood flow to the brain bacause of kinking of carotid artery, are not properly analised, investigated, described and classified. Only one case, as far as we know, of obstructive sleep apnea syndrome caused by tortuous internal carotid artery has been published until now. The surgical treatment with resection of proximal redundant segment of internal carotid artery and reimplantation in its anatomical position resolved transient ishaemic attacks and paroxysmal sleep disorders in children. Sleep disorders in patients with kinking of carotid artery could adress the question about the nature of the link between stroke and sleep disorders, which has been found in a significant proportion of patients with paroxysmal cerebral ischaemia caused by kinks and coils. The sleep disorders may be both a risk factor for stroke but also a direct consequence of acute ischaemic transitory or even permanent brain damage. There are some data supporting the hypothesis of a cause-effect relationship between sleeping disorders and brain ischaemia. Comparation between sleep disorders symptoms and signs in patiens with kinking of carotid artery pre and postoperatively (resolved symptoms) could be sutable model for design of investigation of the relationship between brain ischaemia and sleep disorders.