Perivascular abnormality in the right carotid space, directly related to the right common carotid artery, characterized by T2 hyperintensity and enhancement with only minor luminal narrowing and no intimal flap. The appearances and clinical presentation suggest carotidynia/transient perivascular inflammation of the carotid artery (TIPIC) syndrome. Carotid dissection is considered less likely given the degree of surrounding enhancement and perivascular predominance of the abnormality.