A Rare Encounter in Primary Care: Internal Carotid Artery Agenesis- Case Report

Headache is a quite common presenting complaint in primary care. Detailed examination and imaging are essential for differential diagnosis, as they can reveal various underlying pathologies. In this article, we present a case of internal carotid artery (ICA) agenesis which is detected during the investigation for headache. A patient presented to the family medicine clinic with a two-month history of persistent headache. The general examination did not reveal any pathology or neurological signs. Due to a family history of aneurysms, the patient was referred to the hospital for imaging. Magnetic Resonance Angiography showed unilateral ICA agenesis in the patient, and the patient was placed under follow-up to prevent accompanying cerebrovascular diseases. ICA agenesis often follows a symptomatic course but occasionally manifests with neurological symptoms. When this condition is detected, taking vascular protective measures and recommending lifestyle changes can be long-term steps to prevent pathologies such as aneurysm rupture or ischemia for the patient.