Bilateral hypoplasia of the intracranial internal carotid arteries: A case report and literature review

RATIONALE: The simultaneous occurrence of bilateral internal carotid artery hypoplasia (ICAH) is even rarer. Since the internal carotid artery supplies blood to the anterior circulation of the brain, covering the anterior 2/3 of the cerebral region, this condition increases the risk of cerebrovascular disease and may lead to severe clinical consequences such as dizziness, transient ischemic attack, cerebral infarction, or aneurysms. Currently, the pathogenesis is unclear. PATIENT CONCERNS: A 47-year-old woman was admitted with dizziness as the chief complaint. DIAGNOSES: The computed tomography angiography revealed bilateral ICAH. INTERVENTIONS: The patient was treated with betahistine hydrochloride. OUTCOMES: Symptoms resolved after treatment, and the patient was discharged. Up to now, the patient's symptoms have not recurred, and the condition is stable. LESSONS: Bilateral ICAH is extremely rare. Computed tomography angiography or magnetic resonance angiography is mandatory for diagnosis. Clinical management focuses on symptomatic treatments such as improving circulation.