Findings
-The CXR demonstrates median sternotomy wires, a widened mediastinum, and absent aortic knob.
-The CT demonstrates a high cervical arch.
Discussion
-Cervical aortic arch anomaly is a rare congenital entity. The aortic arch extends into the soft tissues of the neck before turning downward on itself to become the descending aorta. It can be either right or left sided. It can present clinically as a pulsating neck mass.


http://eradiology.bidmc.harvard.edu/Classics/item.aspx?section=Emergency+Radiology&labelpk=33f0adab-853f-4010-a0e2-0756b3f1eac5&pk=562f861c-8be4-494f-a89a-fe5d2945a4e9