The missed missing hole
At times in clinical neurology, the identification of a subtle clinical or radiological sign can lead to prompt diagnosis of a very rare or difficult case. We report on a patient who presented with untreatable headache and unilateral ptosis. Computed tomography (CT) scan of the head did not reveal any structural cause. Magnetic resonance angiogram showed absence of left internal carotid artery, which was eventually confirmed by a catheter angiography. Reviewing the case, it emerged that a feature on the initial CT scan "bone window" would have confirmed the diagnosis, had it been searched for: the underdeveloped carotid canal, which is a consequence and a marker of internal carotid artery agenesis.
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Academia Brasileira de Neurologia - ABNEURO
2012
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| Online Access: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2012000600015 |
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oai:scielo:S0004-282X20120006000152012-06-11The missed missing holePorto,Fábio Henrique de GobbiSilva,Mari-Nilva Maia daDomingues,João Roberto SalaPorto,Gislaine Cristina Lopes MachadoDavagnaman,IndranNitrini,Ricardo carotid artery agenesis Horner syndrome carotid canal underdevelopment computed tomography At times in clinical neurology, the identification of a subtle clinical or radiological sign can lead to prompt diagnosis of a very rare or difficult case. We report on a patient who presented with untreatable headache and unilateral ptosis. Computed tomography (CT) scan of the head did not reveal any structural cause. Magnetic resonance angiogram showed absence of left internal carotid artery, which was eventually confirmed by a catheter angiography. Reviewing the case, it emerged that a feature on the initial CT scan "bone window" would have confirmed the diagnosis, had it been searched for: the underdeveloped carotid canal, which is a consequence and a marker of internal carotid artery agenesis.info:eu-repo/semantics/openAccessAcademia Brasileira de Neurologia - ABNEUROArquivos de Neuro-Psiquiatria v.70 n.6 20122012-06-01info:eu-repo/semantics/articletext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2012000600015en10.1590/S0004-282X2012000600015 |
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Porto,Fábio Henrique de Gobbi Silva,Mari-Nilva Maia da Domingues,João Roberto Sala Porto,Gislaine Cristina Lopes Machado Davagnaman,Indran Nitrini,Ricardo |
| spellingShingle |
Porto,Fábio Henrique de Gobbi Silva,Mari-Nilva Maia da Domingues,João Roberto Sala Porto,Gislaine Cristina Lopes Machado Davagnaman,Indran Nitrini,Ricardo The missed missing hole |
| author_facet |
Porto,Fábio Henrique de Gobbi Silva,Mari-Nilva Maia da Domingues,João Roberto Sala Porto,Gislaine Cristina Lopes Machado Davagnaman,Indran Nitrini,Ricardo |
| author_sort |
Porto,Fábio Henrique de Gobbi |
| title |
The missed missing hole |
| title_short |
The missed missing hole |
| title_full |
The missed missing hole |
| title_fullStr |
The missed missing hole |
| title_full_unstemmed |
The missed missing hole |
| title_sort |
missed missing hole |
| description |
At times in clinical neurology, the identification of a subtle clinical or radiological sign can lead to prompt diagnosis of a very rare or difficult case. We report on a patient who presented with untreatable headache and unilateral ptosis. Computed tomography (CT) scan of the head did not reveal any structural cause. Magnetic resonance angiogram showed absence of left internal carotid artery, which was eventually confirmed by a catheter angiography. Reviewing the case, it emerged that a feature on the initial CT scan "bone window" would have confirmed the diagnosis, had it been searched for: the underdeveloped carotid canal, which is a consequence and a marker of internal carotid artery agenesis. |
| publisher |
Academia Brasileira de Neurologia - ABNEURO |
| publishDate |
2012 |
| url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2012000600015 |
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| _version_ |
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