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AJNR - American Journal of Neuroradiology

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American Journal of Neuroradiology 22:1953-1959 (November 2001)
© 2001 American Society of Neuroradiology

BRAIN

Congenital Absence of the Internal Carotid Artery: Case Reports and Review of the Collateral Circulation

Curtis A. Given II^a, Frank Huang-Hellinger^a, Michael D. Baker^a, Neeraj B. Chepuri^a and P. Pearse Morris^a

^a From the Department of Neuroradiology, Wake Forest University Baptist Medical Center, Winston-Salem, NC (C.A.G., M.D.B., N.B.C., P.P.M.); and the Department of Radiology, Florida Hospital, Orlando, FL (F.H-H.).

Summary: Absence of the internal carotid artery (ICA) is a rare congenital anomaly. The embryology of the ICA and the common collateral pathways associated with its congenital absence are reviewed, with four new cases provided for illustration. While collateral blood flow may allow these patients to remain asymptomatic, two of our patients presented with transient ischemic attacks. Recognition of this anomaly has important implications during planned carotid or transsphenoidal surgery, in thromboembolic disease, and in the surveillance and detection of associated cerebral aneurysms.

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