Case of the Week
Section Editors: Matylda Machnowska1 and Anvita Pauranik2
1University of Toronto, Toronto, Ontario, Canada
2BC Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
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October 28, 2013
Agenesis of the Internal Carotid Artery
- Agenesis of internal carotid artery (ICA) is a rare congenital anomaly due to insult in the early stage of embryogenesis.
- Asymptomatic if collateral flow is adequate. Transient ischemic attack and subarachnoid hemorrhage are possible clinical presentations.
- Key Diagnostic Features: Both ICA and carotid canal at skull base are absent. Most common type of collateral flow is through the circle of Willis, followed by persistent embryonic vessels, or from transcranial collaterals via external carotid artery. Up to one-third of patients have associated cerebral aneurysms.
- DDx: Occlusion of ICA
- Rx: Recognition of agenesis of ICA is particularly important in case of thromboembolic disease or before planning of carotid endarterectomy.
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