Fig. 7
From: Imaging assessment of penetrating injury of the neck and face
a Axial MDCTA image of a 9-year-old patient who sustained accidental penetrating injury by a wooden stick to zone 2 of the right neck. The stick was removed at the time of the injury by the patient’s friend but there is dissection occlusion of the right internal carotid artery; only the external carotid artery, one of its branches and the vertebral artery are visible on this side. The normal left internal carotid artery is annotated for comparison (blue arrow). The patient escaped any significant complicating cerebrovascular ischaemic event. b Axial source image of two-dimensional time of flight MR angiogram of the same patient as in a, performed 4 years later as part of follow-up assessment. The previously injured right internal carotid artery has re-canalised (in keeping with the natural history of dissection injury) but exhibits residual focal stenosis (red arrow) compared with the normal contralateral left internal carotid artery (blue arrow)