Congenital absence of bilateral common carotid arteries

Case contributed by Anil Rawat
Diagnosis certain

Presentation

A 15 year old male child came with complains of headache and neck pain for 1 year.

Patient Data

Age: 15
Gender: Male

NCCT Cervical Spine shows Atlanto-Axial dislocation, Os-Odontoideum, multiple block vertebrae and posteriorly displaced dens causing narrowing of the foramen Magnum leading to cervico-medullary kink.

MR Angiography with time of flight sequence revealed origin of bilateral External Carotid arteries from Brachiocephalic Trunk with absent Common Carotid arteries on both side. Right Internal Carotid artery is directly arising from Brachiocephalic Trunk and Left Internal Carotid Artery is arising from Arch of Aorta.

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