Abstract
Three-dimensional computed tomography angiography (3D-CTA) indicated for the diagnosis of agenesis of the internal carotid artery in a 51-year-old male admitted to our hospital with head trauma. Magnetic resonance (MR) imaging revealed dilated vertebral artery and absence of the flow voids corresponding to the bilateral internal carotid arteries. MR angiography also showed absence of the bilateral internal carotid arteries. 3D-CTA revealed the absence of the bilateral carotid canals and internal carotid arteries, and the dilated basilar artery supplying the anterior and middle cerebral arteries via the bilateral posterior communicating arteries. Aortography showed thickened vertebral arteries and thinned common carotid arteries. Bilateral carotid angiography demonstrated the absence of the internal carotid arteries. Vertebral angiography revealed thickened vertebrobasilar arteries, and supply of the bilateral anterior and middle cerebral arteries via the ipsilateral posterior communicating arteries. 3D-CTA can demonstrate absence of the carotid canal, which is a skull base disease, and absence of the internal carotid artery, which is a cerebrovascular disease. Therefore, 3D-CTA can provide a diagnosis of agenesis of the internal carotid artery.
