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Non-visualization of the internal carotid artery with a normal ipsilateral common carotid artery Doppler waveform: a finding suggesting congenital absence of the ICA on colour Doppler ultrasound

¹ Sosyal Sigortalar Kurumu, Izmir Teaching Hospital, Department of Radiology, Bozyaka, Izmir, ² Sifa Medical Center, Department of Radiology, Basmane, Izmir, Turkey

View larger version (157K): [in a new window]   Figure 1. A 39-year-old woman with left-sided facial numbness. Cranial MRI shows loss of the left cavernous internal carotid artery (ICA) flow void (arrow). Note the normal flow void of the right cavernous ICA (arrowhead).

View larger version (75K): [in a new window]   Figure 2. (a) The left common carotid artery (CCA) demonstrates normal flow throughout systole and diastole. (b) The single vessel beyond the carotid bulb shows prominent diastolic flow; not a typical feature of the external carotid artery (ECA). (c) A longitudinal colour Doppler ultrasound demonstrates a branching artery (arrow) which correctly identifies the single artery as the ECA.

View larger version (67K): [in a new window]   Figure 3. Consecutive CT images through the skull base reveal a diminutive left carotid canal(black arrows). The right carotid canal is normal (white arrows).

View larger version (150K): [in a new window]   Figure 4. A transverse 3D time of flight MR angiogram fails to visualize the left intracranial internal carotid artery(ICA). Note the normal right intracranial ICA (arrow). No aneurysm of the circle of Willis is seen.