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Kissing carotids

Case contributed by Paresh K Desai
Diagnosis almost certain

Presentation

Head injury. MRI carried out three days post injury.

Patient Data

Age: 75 years
Gender: Male

Note: This case has been tagged as "legacy" as it no longer meets image preparation and/or other case publication guidelines.

mri

Incidental finding of anomalous cavernous segment of internal carotid arteries, in which they lie in the midline; in contact with each other or separated by a few millimeters.

Case Discussion

Kissing carotids are a rare variant of the carotid arteries, referring to tortuous and elongated vessels that deviate medially to touch in the midline (or are in close proximity at this point) 1. Kissing carotids may be retropharyngeal or intrasphenoid.

This finding may mimic pituitary disease (both in terms of clinical presentation and on imaging) or complicate transsphenoidal surgeries if not appropriately identified.

The patient also had an incidental basilar invagination.

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