Grade 4 LICA Dissection

Findings:

Multiple CTA images demonstrate marked luminal irregularity and multifocal stenosis of the left internal carotid. A linear filling defect is seen at the C1-2 level on axial images. An irregular outpouching of contrast is present in this region due to a pseudoaneurysm. Distally at the level of the petrous cavernous ICA junction, there is a rounded occlusive filling defect. There is also subtle luminal irregularity of the right internal carotid with a small lateral outpouching seen on the coronal MIP image.

Discussion/Differential Diagnosis:

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