Congenital absence of the internal carotid artery

A case of a 27 year old male who was found to have the unusual congenital absence of one internal carotid artery is presented. A second case with similar but slightly different X-ray findings due to occlusion of the internal carotid is presented for comparison. Only forty cases of agenesis of the internal carotid artery have been found by us in the literature and this appears to be the first from Africa.