  Case of the Week - Patient Summary 1088Peer Reviewed and Certified - | |
| Demographics: 20 y.o. man | |
| History & Chief complaint: | |
| Chronic headache | |
| Physical exam and Laboratory: | |
| Normal Exam | |
| Summary of Findings: | |
| Medial displacement of the flow void for the carotid arteries into the sphenoid bone, below the pituitary gland and fossa. | |
| Differential Diagnosis: | |
| Normal variant - 'kissing carotids' . | |
| Diagnosis: | |
 "kissing" carotid arteries | |
| A portion of the internal carotid artery (the carotid 'siphon') normally travels within the venous cavernous sinus, on either side of the sphenoid bone and pituitary fossa. However, the position of the "cavernous carotid" can be quite variable, with medial displacement into the pituitary fossa and/or into the sphenoid sinus.
One important variant is the intrasellar carotid, another is the "kissing" carotid - where both cavernous carotid arteries deviate medially and touch each other near the midline within the sphenoid bone or the sphenoid sinus. These anomalies are particularly important since they may cause or mimic pituitary disease. They also may complicate transphenoidal surgery. | |