Persistent double dorsal aorta in patient with cavernous sinus thrombosis: A case report

Persistent double dorsal aorta is a rare congenital anomaly of the descending aorta in which the descending aorta is divided into 2 lumens below the ligamentum arteriosum. There are only a few cases reported to date. A 52-year-old female presented with right ptosis since 2 months prior. Neurological examination was significant for cavernous sinus syndrome in the right eye. Digital subtraction angiography revealed right cavernous sinus thrombosis and an incidental finding of double lumen descending aorta, with separation of the second lumen at the level of the thoracic aorta. Computed tomography angiography confirmed a type 2 persistent double dorsal aorta. Persistent double dorsal aorta consists of 2 types. Type 1 is the complete separation of the 2 descending aorta and type 2 is the double lumen descending aorta separated by a dividing septum. Multiplanar 3D reconstruction Computed tomography angiography or magnetic resonance angiography is important to differentiate between this anomaly and acquired conditions such as aortic dissection. In persistent double dorsal aorta, both lumens constitute the true lumen, and branch into the visceral arteries before ending up as the right and left common iliac arteries, respectively, while in aortic dissection, one is a false lumen and does not give a branch to visceral vessels. Persistent double dorsal aorta is a rare congenital anomaly of descending aorta which manifests as 2 separate aorta or 2 lumens of aorta separated by a dividing septum. Knowledge of this anomaly is paramount for interventional neuroradiologists to distinguish it from acquired lesions.