Presentation
Dizziness of short duration.
Patient Data
Age: 40 years
Gender: Female
From the case:
Aplasia of the internal carotid artery
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- complete absence of the intracranial part of the left internal carotid artery
- total absence of the osseous left carotid canal
- left middle cerebral artery is supplied from the posterior circulation
- hypoplastic P1 segment of the left PCA with large PCOM (fetal PCOM)
Case Discussion
Left internal carotid artery (ICA) aplasia with fetal posterior communicating cerebral artery.
The most important radiologic landmark is the carotid canal. In ICA hypoplasia, the carotid canal is present but reduced in caliber. In ICA aplasia, the canal is completely absent 1.
Fetal origin of the left PCA and prominent left P1 suggest that the left MCA is being supplied primarily from the posterior circulation.
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