Ascending pharyngeal artery arising from internal carotid artery

Case contributed by Francis Fortin


Suspected vertebral artery dissection

Patient Data

Age: 50 years
Gender: Female

There was no evident vertebral artery dissection.

As variant anatomy, the right ascending pharyngeal artery is seen originating from the internal carotid artery (ICA) immediately after its bifurcation from the common carotid artery (CCA), rather than its usual origin from the external carotid artery (ECA), as can be seen normally on the left.

Annotated images

Annotated image

On the right, there is an anomalous origin of the ascending pharyngeal artery from the internal carotid artery after it's bifurcation from the common carotid. Bilaterally, the ascending pharyngeal arteries can be seen coursing superiorly, between the posterolateral pharynx and the internal carotids. On the sagittal oblique multiplanar reconstruction (MPR) images, the origin of the right occipital artery is seen and should not be confused with the ascending pharyngeal.

Case Discussion

Very rarely, the ascending pharyngeal artery can arise from the ICA, either as an isolated variant or as part of more complex variant anatomy 1,2,3. It is important to recognize and mention this variant, especially if carotid surgery is being planned.

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