A 46-year-old patient presented with a history of sudden loss of vision in the right eye. Evaluation at an ophthalmology institute led to the diagnosis of right retinal artery thrombosis. Interestingly, the patient had no other neurological deficits. Further investigations, including carotid Doppler and MRA, suggested a right internal carotid artery block. However, the absence of stroke symptoms despite this finding raised clinical suspicion.
Blood investigations, including homocysteine and D-dimer levels, were within normal limits. On reviewing the MRI CD and correlating clinically, a rare diagnosis of congenital absence of the right internal carotid artery was considered. Literature review suggests that only around 100 such cases have been reported worldwide, with limited data from India. The patient was evaluated by a neurologist and started on antiplatelet therapy.…
