case_images: PMC3843907_01
case_images: Transesophageal echocardiography describing the right coronary sinus to the right ventricular shunt. This was performed before the surgery for the rupture of a congenital SVA.
case_images: crn-0005-0195-g01.jpg
case_images: PMC3843907_01_crn-0005-0195-g01.jpg
case_images: F1
case_images: He had a history of a SVA rupture that was surgically treated at the age of 24 (fig. 1).
case_images: MRI (a) did not detect a reasonable high-intensity area with diffusion-weighted imaging. In addition,123 I iofetamine single-photon emission computed tomography brain imaging (b) did not detect any areas of abnormal blood flow.
case_images: crn-0005-0195-g02.jpg
case_images: PMC3843907_01_crn-0005-0195-g02.jpg
case_images: F2
case_images: Although we performed magnetic resonance imaging (MRI) with a 1.5-tesla unit on the first day and with a 3-tesla unit 2 weeks later, acute cerebral infarction was not detected (fig. 2a).
case_images: Conventional cerebral angiography revealed that the left ICA (arrow) was hypoplastic and the carotid bifurcation was low-lying at the level of the C6 vertebra (a). The ACA was of the azygos type, and the left middle cerebral artery was visualized through the anterior communicating artery by the right conventional coronary angiography (b). The left ICA did not have stenosis (c). The left external carotid artery flow did not supply the ICA (d).
case_images: crn-0005-0195-g03.jpg
case_images: PMC3843907_01_crn-0005-0195-g03.jpg
case_images: F3
case_images: Thereby, cerebral angiography was conducted, and it showed hypoplasty of the left ICA and a low-lying carotid bifurcation at the level of the C6 vertebra (fig. 3a). The A1 segment of the bilateral anterior cerebral arteries (ACAs) was united and formed an azygos type (fig. 3b).