Spontaneous right internal carotid artery dissection
Neck pain for 4 days with mild left foot and leg weakness.
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Reduced signal intensity in the right ICA and branches compared with the left ICA indicating a critical stenosis proximally. Reduced right ICA T2 flow void.
High signal on T1FS indicating methemoglobin in terminal right ICA wall.
Segmented contrast angiogram of right ICA showing a tapered narrowing of the distal right ICA (arrowed).
No restriction of diffusion.
Apparent spontaneous dissection of the terminal right ICA with cerebral infarct. There is usually a history of trauma. No obvious underlying cause in this case but must be concerned for fibromuscular dysplasia. Terminal left ICA looks normal.