PMC6362309_01
Extracranial CTA: Diffuse severe left ICA narrowing from 0.5 cm beyond the carotid bifurcation (arrows), consistent with "Alagille vasculopathy."
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F1
Extracranial MRA (not shown) and CTA (Figure 1) revealed a diffusely-narrowed left ICA.
Formal Catheter Angiography: Sagittal views following left carotid injection showed >=75% extracranial LICA stenosis (arrow). LICA was occluded in the supraclinoid segment after the left ophthalmic artery origin with moyamoya phenomenon (not shown).
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F2
Formal cerebral angiography confirmed severe left ICA narrowing suspicious of either prior left ICA dissection or vasculopathy (Figure 2), and confirmed moyamoya phenomenon in the anterior and posterior circulations (Figure 3).
AP views following left vertebral artery injection showed moyamoya phenomenon around the proximal left PCA (arrow).
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F3
Formal cerebral angiography confirmed severe left ICA narrowing suspicious of either prior left ICA dissection or vasculopathy (Figure 2), and confirmed moyamoya phenomenon in the anterior and posterior circulations (Figure 3).