Internal carotid artery dissection

Case contributed by Assoc Prof Frank Gaillard

Presentation

Right hemiplegia of over 24 hours' duration.

Patient Data

Age: 60 years
Gender: Male

Patchy left hemispheric and left basal ganglia hypodensities.

Occluded left internal carotid artery with perhaps a faint crescent sign seen on fat saturated T1 images through the neck, although note the mimicking appearance of flow in the adjacent jugular and contralateral ICA. 

Case Discussion

Features are consistent with ICA dissection and infarction presumably from artery to artery embolism, rather than occlusion (patchy infarction, not in a watershed distribution). 

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