A 79-year-old woman with dysphagia
A
B
What is your diagnosis?
The answer is Kissing Carotids
「Kissing carotids」 is a developmental variation of the internal carotid arteries in which the bilateral internal carotid arteries course medially in close proximity in the midline (A, arrow).
The levels in which the carotid arteries come close in proximity can be found at the retropharynx, sella turcica, and intrasphenoid.
In the present case, the kinked carotid segments lie anterior to the vertebral body and submucosal to the pharyngeal wall (B, arrow), which may impose potential risk to the patient if a pharyngeal biopsy is to be done.
中文版：
女性，79歲，吞咽困難
診斷：「吻頸」畸形
「吻頸」畸形是頸內動脈的一種發育異常，雙側頸內動脈向內側彎曲走形，至中線部位相互貼近（A圖箭頭）。
頸內動脈相貼近的部位常發生於咽後部、鞍區以及蝶骨水平。
本病例中，走形扭曲的頸內動脈位於椎體前方，緊貼於咽後壁黏膜下（B圖箭頭），如行咽部活檢，則對頸內動脈有潛在的損傷風險。
From AJNR Classi Case