We wish to thank Nomura et al1 for sharing the unique case study entitled, “Agenesis of the left internal carotid artery (ICA) associated with dolichoectatic intracranial arteries.” The authors discussed the radiological findings and association of left internal carotid artery (ICA) agenesis and dolichoectatic intracranial arteries which was probably related to hemodynamic stress. Association of agenesis of ICA with intracranial aneurysm has been described in the literature.2

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