Agenesis of Bilateral Internal Carotid Artery Associated With Basilar Artery Fenestration Mimicking Intra-arterial Thrombus: A Case Report

Abstract

Bilateral internal carotid artery agenesis is a very rare congenital anomaly, which may be accompanied by various types of associated vascular abnormalities, included intracranial aneurysms or dolichoectatic change of posterior circulation. In this article, we present unique, and to the best of our knowledge, the first case of bilateral internal carotid agenesis associated with basilar artery fenestration, which resembles intra-arterial floating thrombus.

Basilar Artery Thrombus vs. Fenestration: A Differential Diagnostic Challenge in Acute Ischemic Stroke

“…Correct diagnosis is not always simple, especially in cases of small arterial thrombi that lead to a paucisymptomatic clinical presentation. Arterial fenestration can resemble an arterial thrombus on diagnostic imaging . Basilar artery (BA) fenestration is the most common intracranial arterial fenestration having an incidence of up to 5.26% in the general population .…”

“…Arterial fenestration can resemble an arterial thrombus on diagnostic imaging. 2 Basilar artery (BA) fenestration is the most common intracranial arterial fenestration having an incidence of up to 5.26% in the general population. 3 It results from incomplete fusion of primitive embryologic vessels.…”