PMC9871402_01
Absence of bilateral internal carotid arteries with multiple intracranial aneurysm but no acute infarction. (A) Three-dimensional CTA assessment shown physiological anatomy of six large vessels supplying the brain, in which the common carotid artery is further divided into external carotid arteries (ECA) and ICA. (B) The patient had no ICA (Area 1) with enlarged vertebrobasilar arteries and ECA. Aneurysm appeared in basilar artery (Area 2) and left anterior cerebral artery A2 segment (Area 3). (C) Intracranial vascular reconstructed with maximum intensity projection (MIP) (D) Curvature plane reconstruction for basilar artery aneurysm (E) Axial location of bilateral ICA running area (red arrow, no imaging), external carotid artery (blue arrow) and vertebral artery (yellow arrow) as in panel B-Area 4 dotted. (F) Diffusion weighted imaging (DWI) showed no acute cerebral infarction.
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CTA revealed the absence of bilateral internal carotid arteries (ICAs) with compensated artery dilatation, multiple aneurysms, and sclerosis in cephalic and cervical arteries, without acute infarcts in diffusion-weighted images (DWI) (Figure 1). CT scan also revealed hypoplastic carotid canals at both sides in bone window (Figure 2).
CT scan reveals hypoplastic carotid canals at both sides in the patient. (A) The ICA enters the skull through the carotid canals (red circle) in healthy control, (B) while the patient had none.
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CTA revealed the absence of bilateral internal carotid arteries (ICAs) with compensated artery dilatation, multiple aneurysms, and sclerosis in cephalic and cervical arteries, without acute infarcts in diffusion-weighted images (DWI) (Figure 1). CT scan also revealed hypoplastic carotid canals at both sides in bone window (Figure 2).