Misdiagnosis of a Patient with Internal Carotid Artery Fenestration: A Case Report and Literature Review.

BACKGROUND: Internal carotid artery fenestration is a rare congenital cerebrovascular condition and can be misdiagnosed as carotid artery dissection.

CASE REPORT: A patient was initially misdiagnosed with carotid artery dissection. This initial diagnosis was made using a carotid vascular computed angiography and magnetic resonance angiography. A digital subtraction angiography examination revealed a fenestration in the terminal C1 segment of the right internal carotid artery. Previous literature related to carotid artery fenestration was reviewed and analyzed.

CONCLUSIONS: Fenestration of the carotid artery combined with aneurysm at the external segment of the internal carotid artery or from the starting position of the carotid artery remains rare in elderly patients, can be misdiagnosed as artery dissection.