(c) Frontal right internal carotid artery
angiogram showing occlusion of the distal middle cerebral artery M1 segment (grey arrow).
CT angiography of cervical vessels showing complete occlusion of the right internal carotid artery
Table-2 shows the comparison of intimal thickness of right common carotid artery (RCCA), right internal carotid artery
(RICA), left common carotid artery and left internal carotid artery between control group, hypertensive, patients with diabetes and patients with both diabetes and hypertension [Table-2]
There was encasement of the right internal carotid artery
. The mass lesion appears to displace intraorbital optic nerve superomedially resulting in moderate atrophy of the same.
Angiograms demonstrated stenosis of proximal segment (85%) of right internal carotid artery
with signs of the atherosclerotic plaque ulceration (Figure 1a).
On imaging with four-vessel angiography and computed brain tomography, a bullet was noted in the right internal carotid artery
with no distal flow, the circle of Willis was patent, and a right fronto-parietal infarct was seen on the brain scan (Figs 1 and 2).
The lesion abutted the right medial temporal lobe, the right internal carotid artery
, and the basilar artery.
The carotid ultrasound/Doppler study showed normal right common carotid artery (Figure 1), right internal carotid artery
(ICA; Figure 2), and external carotid artery, with normal color flows and Doppler waveforms.
For the right internal carotid artery
, the bottom (occlusion) category is selected from the left vertical column and the far right (occlusion) category is selected from the top horizontal row.
Right internal carotid angiogram showed complete occlusion of the right middle cerebral artery and the formation of moyamoya vessels in the basal ganglia and a persistent primitive trigeminal artery (PPTA) that branched from the C4 portion of the right internal carotid artery
and terminated at the upper portion of the basilar artery [Figure 1]c.
IMT far wall of right internal carotid artery
Multiple dural feeders were also seen arising from meningeal branches of occipital and superficial temporal branches of both external carotid and right internal carotid artery
. Drainage was peripherally in to superior sagittal sinus.