Asymptomatic carotid rete mirabile and contralateral carotid agenesis: a case report

Carotid rete mirabile (CRM) is a physiological network between the external carotid artery (ECA) and internal carotid artery (ICA) in lower mammals. It is a transdural arterial network centered at the parasellar area, in anatomical localization of intracavernous or petrous segment of ICA, associated with hypoplasia or absence of the cervical or petrous segment of ICA. It clinically presents as hemorrhagic or ischemic cerebrovascular disorder. Carotid rete mirabile have an angiographic frequency of 0.01%. The authors present a new case of right ICA agenesis supported by primary collateral channels associated with left hypoplasic ICA and CRM. It is an unusual entity and we highlight the role of CRM in cerebral hemodynamic in this asymptomatic vascular patient. Our aim is detail the angiographic features and diagnosis criteria of CRM.