[A case of absence of the left internal carotid artery]

A case of absence of the left internal carotid artery with epilepsy was reported. Only a few cases of absence of the internal carotid artery with epilepsy in childhood have been reported in Japan. A flow void image of the cavernous sinus portion of the left internal carotid artery was not obtained on MRI. MR angiography and digital subtraction angiography also did not reveal the left internal carotid artery. On thin slice, axial CT scanning of the skull base, the right carotid canal was normally observed, but the left carotid canal was hypoplastic. It was suggested that the epileptic focus was in the right hemisphere, judging from the fast waves dominant over the right hemisphere on ictal EEG, and the hyperfusion in the right parietal and occipital lobes seen on 99mTc-HMPAO SPECT one hour after the seizure.