Internal carotid artery aplasia/hypoplasia
Occasional headaches. Her neurologist requested MRI brain to exclude morphological aetiology for the patient's problem.
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There is a complete absence of the left internal carotid artery. There are no significant cerebrovascular sequelae in the brain parenchyma, with only a few punctiform hyperintensities on T2W/FLAIR which are consistent with previous minor ischemic lesions.
Collateral circulation is provided via the anterior and posterior comunnicating arteries.
Otherwise, the MRI brain is unremarkable.
Taking into consideration the patient's age and lack of major ischemic change, the most probable diagnosis in the case is congenital aplasia/hypoplasia of the left internal carotid artery.
This patients risk for a cerebral aneurysm is increased, but no aneurysm has been found in this examination.