Abstract

Agenesis of the bilateral internal carotid arteries is a rare disease. There have been few case reports of subjects who developed cerebral infarction, intracranial hemorrhage or subarachnoid hemorrhage. We experienced a rare case of agenesis of the bilateral internal carotid arteries in which the patient developed vertigo. A 63-year-old woman suddenly became dizzy one morning after waking up and was admitted to our hospital. Brain Computed Tomography (CT) and Magnetic Resonance (MR) imaging demonstrated no intracranial hemorrhage or cerebral infarction. CT angiography and MR angiography showed the enlargement and invagination of the basilar artery into the pons. Her dizziness disappeared with conservative therapy. Our case was very rare because the patient was diagnosed with agenesis of the bilateral internal carotid arteries before the development of major cerebrovascular disease. There are some possible mechanisms of vertigo in our case: One is direct pulsatile pontine compression by the elongated basilar artery; another is transient or chronic cerebral ischemia caused by abnormal circulation.

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