Spontaneous right internal carotid artery dissection

Case contributed by Dr Chris O'Donnell

Presentation

Neck pain for 4 days with mild left foot and leg weakness.

Patient Data

Age: 65 years
Gender: Female

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.

Case Discussion

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.

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Case information

rID: 16306
Published: 9th Jan 2012
Last edited: 27th Sep 2019
Inclusion in quiz mode: Included

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