Incidental finding of aberrant left common carotid artery during intracerebral hemorrhage examination

We report a case involving an aortic arch anomaly that has not been previously documented. The patients were a 76-year-old female who was urgently transported to the hospital because of a sudden disturbance of consciousness. Neurological symptoms indicated impending brain herniation, and the patient was diagnosed with hypertensive intracerebral hemorrhage (left putamen-thalamus) and acute hydrocephalus, thereafter she died approximately 6 hours after arrival. Head and neck-to-chest computed tomography angiography revealed an atypical aortic arch branching pattern. From the proximal side, the left common carotid artery, right common carotid artery, right subclavian artery, and left subclavian artery originated sequentially, suggesting an aberrant left common carotid artery. In the context of acute stroke management, understanding such aortic arch variations is crucial for planning access routes and treatment strategies for neuroendovascular procedures.