Internal Carotid Artery Dissection

These images demonstrates a 2.5 cm “flow gap” of the right internal carotid artery approximately 3 cm distal to the carotid bifurcation. T1 images show hyperintensity in the vessel wall compatible with hemorrhage resulting in near occlusion of the vessel. Findings represent dissection and this location is the most common site. 20% of ICA dissections are bilateral or involve the vertebral arteries. The etiology of dissection can be grouped into post-traumatic, idiopathic/spontaneous, or those resulting from an underlying arteriopathy such as marfan’s syndrome. Treatment usually entails anticoagulation therapy unless contraindicated by intracranial hemorrhage.