Case 2: 14-year-old boy with headache, vomiting, dizziness, and ringing in the ear. Case 2: 14-year-old boy with headache, vomiting, dizziness, and ringing in the ear. A, Axial CT scan shows a normal right foramen spinosum (arrow) and absence of the left foramen spinosum.B, Coronal CT scan shows the aberrant ICA on the left (straight arrow) and the soft-tissue density of a PSA (curved arrow).C, Left carotid arteriogram, lateral view, shows a PSA arising from the aberrant ICA (arrow).D, Left carotid arteriogram, frontal view, shows a PSA arising from the aberrant ICA (arrow). Richard Silbergleit et al. AJNR Am J Neuroradiol 2000;21:572-577 ©2000 by American Society of Neuroradiology