Presentation
Incidental finding. History of subacute left hemispheric cerebral infarction, left internal carotid artery stenosis.
Patient Data
On contrast-enhanced MRI, the internal carotid arteries on both sides are elongated and tortuous, touching each other (kissing) at the midline at the level of the retropharynx.
Nodular and plaque-like contrast enhancement, scattered in the left cerebral hemisphere and gyral regions; consistent with subacute cerebral infarction.
Cystic structure in the posterior fossa, suggestive of an arachnoid cyst.
Eccentric wall thickening causing moderate stenosis of the carotid bulb in the left internal carotid artery, possibly due to atherosclerotic plaque.
Case Discussion
The imaging findings are consistent with kissing carotids.
This is an incidental finding, and it is significant for surgeons when approaching the transsphenoidal or retropharyngeal regions.
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