Internal carotid artery transposition: another cause of widening of the retropharyngeal space

We present four cases of internal carotid artery (ICA) transposition which caused widening of the retropharyngeal soft tissues. Internal carotid arter y transposition is a rare cause of retropharyngeal Space enlargement, which can be accurately diagnosed in a non-invasive manner with spiral CT. Radio logists should be aware of this entity in the differential diagnosis of ret ropharyngeal space enlargement in symptomatic (dysphagia, pulsatile mass) a nd asymptomatic patients, and alert the clinician of its existence, due to the risk of massive bleeding if neck surgery is to be performed.