DOI: 10.36347/sasjm.2023.v09i07.001

Pages: 734-736

Internal carotid artery agenesis is a very rare anomaly, occurring during the early stages of embryonic development. We report the clinical presentation and imaging findings both on CT and MRI of the incidental finding of a left internal carotid agenesis in a 40 year old female. Magnetic resonance angiography was the most valuable diagnostic tool for the positive diagnosis, showing the absence of the left internal carotid artery, with left circulation arising from the right anterior cerebral artery and left posterior cerebral artery. Unenhanced computed tomography was used to differentiate between internal carotid agenesis and hypoplasia. Imaging should also look for associated malformations such as aneurysms as well as ischemic and hemorrhagic complications.