Unusual case of traumatic cervical internal carotid artery dissection presenting as pseudofenestration

Internal Carotid Artery Pseudofenestration: A Case Report

“…The authors also point out that the occurrence of a stroke, as seen in one of the initially reported cases, should prompt consideration of an underlying dissection with a double-lumen [ 1 ]. Interestingly, the aforementioned vascular observations were absent in an unusual case of an ICA pseudofenestration in a patient presenting with a transient ischemic attack described by Gesheva et al [ 2 ]. In this case, the vessel limbs appeared very regular and smooth on angiographic evaluation without evidence of pseudoaneurysm, dissection, or vessel wall irregularity.…”

“…ICA fenestrations are extremely rare. The underlying embryological mechanism is merely a hypothesis [ 2 ]. Thus, some authors question its existence [ 2 ].…”

“…The underlying embryological mechanism is merely a hypothesis [ 2 ]. Thus, some authors question its existence [ 2 ]. A growing embryo undergoes several complex changes in the ventral and dorsal aorta with regression and fusion of the six aortic arches until the conventional vascular anatomy is developed [ 3 ].…”

“…Congenital anatomic variations of the cervical internal carotid artery (ICA) are exceedingly rare [ 1 - 2 ]. Two variants previously described are ICA fenestration and ICA duplication [ 1 ].…”

Endovascular treatment of blunt injury of the extracranial internal carotid artery: the prospect and dilemma

“…Intramural hematomas present with eccentric/ circumferential mural thickening extending along the long artery [18]. Intimal tears present with subtle mural thickening and contour irregularity, and raised intimal flaps present with a linear pattern of filling defect/false lumen opacification known as the ''double lumen'' sign and even pseudofenestration [41].…”