Congenital absence of the internal carotid artery in a patient with spinal cord injury: case report.
METHODS
Case report.


OBJECTIVE
To describe a rare case of congenital absence of the internal carotid artery (ICA) in the setting of acute spinal cord injury and review the existing literature.


METHODS
Regional Spinal Cord Injury Center of the Delaware Valley, Philadelphia, PA, USA.


METHODS
We report on a 47-year-old male who presented as a T2 ASIA A spinal cord injury with a T2-T3 fracture dislocation injury after a 25-feet fall from a tree. Magnetic resonance angiography imaging of the neck carried out as per routine spinal trauma protocol suggested an acute traumatic injury to the carotid artery. Therefore, computed tomographic angiography imaging of the neck was performed, which revealed absence of the left ICA and a diminutive left carotid canal at the skull base, suggesting congenital absence. Follow-up magnetic resonance imaging of the brain to evaluate for acute infarct showed no diffusion restriction contributing to the evidence that this was a congenital anomaly and not traumatic occlusion of the artery.


CONCLUSIONS
Congenital absence or hypoplasia of the ICA is a rare anomaly. It should be considered in the differential in patients who have absent or diminished carotid arteries on radiologic imaging in the setting of trauma.
Department of Neurological Surgery, Thomas Jefferson University, Philadelphia, PA 19107, USA. sanjay.yadla@jeffersonhospital.org
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Yadla
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Patel
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Jabbour
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Harrop
D002343:Carotid Artery, Internal / Q000002:abnormalities* / Q000000981:diagnostic imaging; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011859:Radiography; D013119:Spinal Cord Injuries / Q000000981:diagnostic imaging* / Q000209:etiology; D016103:Spinal Fractures / Q000150:complications / Q000000981:diagnostic imaging