title: Missed dissection as a result of the ascending pharyngeal artery arising from the internal carotid artery.
abstract: Unlike high-grade stenosis, dissections of craniocervical arteries are a rare cause of cerebrovascular infarction. If the internal carotid artery (ICA) dissection is verified by duplex scanning or computed tomography angiography (CTA), the therapies of choice are antiplatelet and anticoagulation drugs, and surgical treatment is rarely performed. However, despite distinct clinical and radiological manifestation, carotid dissections are still under-recognized. In this study, we demonstrate the case of a 66-year-old man with dissection of ICA verified by duplex scanning and computed tomography angiography. The cause of missed diagnosis was an ascending pharyngeal artery originating from the ICA that runs parallel to it. Other than being a rare variation, this case may be interesting as a cause of misdiagnosis.
authors.affiliation: Department of Vascular Surgery, Institute for Cardiovascular Disease Dedinje, Belgrade, Republic of Serbia. sdrbabic@sezampro.rs
authors.forename: Srdjan
authors.initials: S
authors.lastname: Babic
authors.forename: Anka
authors.initials: A
authors.lastname: Mitrasinovic
authors.forename: Predrag
authors.initials: P
authors.lastname: Gajin
authors.forename: Nenad
authors.initials: N
authors.lastname: Ilijevski
authors.forename: Djordje
authors.initials: D
authors.lastname: Radak
mesh_terms: D000368:Aged; D000784:Aortic Dissection / Q000175:diagnosis* / Q000601:surgery; D001158:Arteries / Q000002:abnormalities; D002340:Carotid Artery Diseases / Q000175:diagnosis* / Q000601:surgery; D002343:Carotid Artery, Internal / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery; D003951:Diagnostic Errors; D016894:Endarterectomy, Carotid; D006801:Humans; D008297:Male; D010614:Pharynx / Q000098:blood supply*; D011237:Predictive Value of Tests; D014057:Tomography, X-Ray Computed; D018615:Ultrasonography, Doppler, Color; D018616:Ultrasonography, Doppler, Duplex; D054079:Vascular Malformations / Q000175:diagnosis*