EURORAD ESR

Case 12578

Agenesis of the Internal Carotid Artery with Intracavernous Anastomosis

Author(s)
Ilias Bagetakos, Max Scheffler

From the Department of Radiology
Geneva University Hospital
Rue Gabrielle-Perret-Gentil 4
1205 Geneva, Switzerland
 
Patient
male, 57 year(s)
 
 
  • Figure 1
    CT
     

    1a, CT angiogram at the level of the second cervical vertebra (C2) shows neck vessels with absent left ICA. Right ICA has increased diameter (white arrow). Note right ECA (black arrow) and left ECA (arrowhead).

     
    Area of Interest: Neuroradiology brain; Imaging Technique: CT-Angiography; Procedure: Diagnostic procedure; Special Focus: Congenital;

    1b, axial oblique reconstructed image of CT angiogram using bone filter shows enlarged right carotid canal (arrow). Note agenesis of left carotid canal.

     
    Area of Interest: Neuroradiology brain; Imaging Technique: CT-Angiography; Procedure: Diagnostic procedure; Special Focus: Congenital;

    1c, axial MIP reconstruction of CT angiogram shows intracavernous anastomosis (black arrow) branching from C4 segment of right ICA (white arrow) and continuing into terminal left ICA (black arrowhead). Note basilar...

     
    Area of Interest: Neuroradiology brain; Imaging Technique: CT-Angiography; Procedure: Diagnostic procedure; Special Focus: Congenital;

    1d, 3D volume rendered reconstruction of CT angiogram shows left MCA (white arrow) coming off intracavernous anastomosis (black arrow). Left A1 segment of ACA is not seen.

     
    Area of Interest: Neuroradiology brain; Imaging Technique: CT-Angiography; Procedure: Diagnostic procedure; Special Focus: Congenital;

    1e, sagittal view of 3D volume rendered reconstruction of CT angiogram shows left A2 segment (arrowhead) with thrombus (black arrow). Left A2 segment comes from right ACA A1 segment (white arrow) via Acom artery.

     
    Area of Interest: Neuroradiology brain; Imaging Technique: CT-Angiography; Procedure: Diagnostic procedure; Special Focus: Congenital;

    1f, native phase of CT angiogram shows focal cortial hypodensity (arrow) in left F2 gyrus.

     
    Area of Interest: Neuroradiology brain; Imaging Technique: CT-Angiography; Procedure: Diagnostic procedure; Special Focus: Congenital;
     
     
  • Figure 2
    MRI
     

    2a, 3D reconstruction of MR angiogram shows absent left ICA. Left MCA (arrowhead) comes from right ICA (white arrow) via intracavernous anastomosis (black arrow).

     
    Area of Interest: Neuroradiology brain; Imaging Technique: MR-Angiography; Procedure: Diagnostic procedure; Special Focus: Congenital;

    2b, DWI sequence shows cortial ischemic lesion already seen on CT (white arrow). Other smaller cortical lesions are seen more posteriorly (black arrow).

     
    Area of Interest: Neuroradiology brain; Imaging Technique: MR-Angiography; Procedure: Diagnostic procedure; Special Focus: Congenital;

    2c, DWI sequence, image of left centrum semi-ovale shows mutiple ischemic lesions in border zone of left ACA and MCA territories (arrows).

     
    Area of Interest: Neuroradiology brain; Imaging Technique: MR-Angiography; Procedure: Diagnostic procedure; Special Focus: Congenital;

    2d, coronal FLAIR sequence shows cortical (arrow) and deep (arrowhead) ischemic lesions in left ACA territory.

     
    Area of Interest: Neuroradiology brain; Imaging Technique: MR-Angiography; Procedure: Diagnostic procedure; Special Focus: Congenital;
     
     
1a, CT angiogram at the level of the second cervical vertebra (C2) shows neck vessels with absent left ICA. Right ICA has increased diameter (white arrow). Note right ECA (black arrow) and left ECA (arrowhead).
 
1b, axial oblique reconstructed image of CT angiogram using bone filter shows enlarged right carotid canal (arrow). Note agenesis of left carotid canal.
 
1c, axial MIP reconstruction of CT angiogram shows intracavernous anastomosis (black arrow) branching from C4 segment of right ICA (white arrow) and continuing into terminal left ICA (black arrowhead). Note basilar artery (white arrowhead).
 
1d, 3D volume rendered reconstruction of CT angiogram shows left MCA (white arrow) coming off intracavernous anastomosis (black arrow). Left A1 segment of ACA is not seen.
 
1e, sagittal view of 3D volume rendered reconstruction of CT angiogram shows left A2 segment (arrowhead) with thrombus (black arrow). Left A2 segment comes from right ACA A1 segment (white arrow) via Acom artery.
 
1f, native phase of CT angiogram shows focal cortial hypodensity (arrow) in left F2 gyrus.
 
2a, 3D reconstruction of MR angiogram shows absent left ICA. Left MCA (arrowhead) comes from right ICA (white arrow) via intracavernous anastomosis (black arrow).
 
2b, DWI sequence shows cortial ischemic lesion already seen on CT (white arrow). Other smaller cortical lesions are seen more posteriorly (black arrow).
 
2c, DWI sequence, image of left centrum semi-ovale shows mutiple ischemic lesions in border zone of left ACA and MCA territories (arrows).
 
2d, coronal FLAIR sequence shows cortical (arrow) and deep (arrowhead) ischemic lesions in left ACA territory.
 
 
 
Home Search Sections Teaching Cases History FAQ Case Archives Contact Login Disclaimer Imprint Switch to MOBILE version
View desktop version