Presentation
Sudden onset headache and vomiting. Lumbar puncture was normal but MRI brain raised the possibility of right ICA dissection or hypoplasia. A CT angiogram was carried out.
Patient Data
Note: This case has been tagged as "legacy" as it no longer meets image preparation and/or other case publication guidelines.
Arch:
Carotid arteries:
Vertebral arteries:
Intracranial arteries:
Impression:
Case Discussion
This case demonstrates a hypoplastic right internal carotid artery. The narrow right carotid canal, fetal right PCA with prominent right P1 artery add further evidence towards this.
Agenesis, aplasia, and hypoplasia of the internal carotid artery (ICA) are rare congenital anomalies, occurring in less than 0.01% of the population.
As in this case the most common type of collateral flow is through the circle of Willis.
Although this case is an incidental finding, recognition is important as it is associated with cerebral aneurysms and has an implication during carotid endarterectomy and transsphenoidal hypophyseal surgery.
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