학술논문

The missed missing hole
Document Type
article
Source
Arquivos de Neuro-Psiquiatria. June 2012 70(6)
Subject
carotid artery agenesis
Horner syndrome
carotid canal underdevelopment
computed tomography
Language
English
ISSN
0004-282X
Abstract
At times in clinical neurology, the identification of a subtle clinical or radiological sign can lead to prompt diagnosis of a very rare or difficult case. We report on a patient who presented with untreatable headache and unilateral ptosis. Computed tomography (CT) scan of the head did not reveal any structural cause. Magnetic resonance angiogram showed absence of left internal carotid artery, which was eventually confirmed by a catheter angiography. Reviewing the case, it emerged that a feature on the initial CT scan "bone window" would have confirmed the diagnosis, had it been searched for: the underdeveloped carotid canal, which is a consequence and a marker of internal carotid artery agenesis.