Abstract

A 42-year-old female was admitted to our hospital with progressively enlarging pulsatile mass in the left lateral cervical region, hoarseness
and pain radiating to left ear. Magnetic resonance angiography demonstrated a left internal carotid aneurysm, which extended from the
carotid bifurcation nearly to the skull base, and a normal internal carotid artery (ICA) segment was found before the artery entered into the
carotid canal. The aneurysmal segment was removed with resection of the bony structures, and direct arterial reconstruction was performed
without any tension or damage to the cranial nerves. Pathological examination showed a true aneurysm with atheromatous changes follow-up
after 2 years revealed a patent ICA.

Key words: Carotid artery; ent to end anastomosis; giant aneurysm; horseness