Bilateral Aberrant Internal Carotid Arteries with Bilateral Persistent Stapedial Arteries and Bilateral Duplicated Internal Carotid Arteries
John D. Rolla,
Martin A. Urbanb,
Theodore C. Larson, IIIa,
Philippe Gailloudc,
Pradeep Jacobd and
H. Ric Harnsbergere
a Departments of Radiology, Vanderbilt University Medical Center, Nashville, TN
b Saint Anthony Medical Center, Rockford, IL
c Johns Hopkins Hospital, Baltimore, MD
d University of Tennessee, Knoxville
e University of Utah, Salt Lake City
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FIG 1. Aberrant ICAs (arrows) in the middle ear.
A, Case 1. CT scan demonstrates bilateral aberrant ICAs.
B, Case 2. CT scan demonstrates left aberrant ICA.
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FIG 2. Absent foramen spinosum.
A, Case 1. CT scan demonstrates bilateral absence of the foramen spinosum. A foramen of Vesalius is noted on this image on the right (arrow) and was present on the left on additional images (not shown).
B, Case 2. CT scan demonstrates a right foramen spinosum on the right (arrow) and absence on the left.
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FIG 3. Thickened contents of the horizontal facial canal.
A, Case 1. CT scan shows bilateral thickening from PSAs.
B, Case 2. CT scan shows left-sided thickening.
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FIG 4. Carotid canals and inferior tympanic canals.
A, Case 1. CT scan shows bilateral hypoplastic carotid canals (horizontal arrows) and enlarged bilateral inferior tympanic canals (vertical arrows) through which the aberrant ICA (inferior tympanic artery portion) passes.
B, Case 2. CT scan shows a normal right carotid canal (horizontal arrow on the patient’s right), a hypoplastic carotid canal (horizontal arrow on the patient’s left), and the inferior tympanic canal (vertical arrow) with the aberrant ICA.
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FIG 5. Case 1. 3D CT scans of the of the exocranial foramen with stereoscopic views. Images A and B are for cross-eyed viewing, and images B and C are for parallel-eye viewing. The right inferior tympanic canal (left arrow) shows a bony constriction. The hypoplastic right carotid canal is shown with the right arrow.
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FIG 6. Case 1. Stereoscopic MRA images of the right carotid. Images A and B are for cross-eyed viewing, and images B and C are for parallel-eyed viewing. The top left arrow shows the PSA supplying the middle meningeal distribution. The right arrow shows the duplicated ICA (carotid branch of the ascending pharyngeal artery). The bottom left arrow points to the turbulent blood flow at the inferior tympanic canal in the aberrant ICA. Views of the left ICA showed similar findings (not shown).
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