Cerebral perfusion imaging in asymptomatic carotid artery occlusion following gun shot

Recognition of brain injury in asymptomatic carotid artery injuries with conventional methods can be difficult. We present a case of angiographically proven asymptomatic left internal carotid artery occlusion with normal CT after a gunshot wound. The SPECT brain perfusion imaging showed mild generalized supratentorial hypoperfusion of the bilateral cerebral cortices on the left side and severe left temporal lobe hypoperfusion.