Acute stroke secondary to internal carotid artery pseudoaneurysm: MRI findings and treatment with endovascular coiling

Internal carotid artery pseudoaneurysms are uncommon. We report a young man with history of trivial trauma who presented with middle cerebral artery stroke. Head CT scan revealed a right parapharyngeal mass. MRI confirmed the diagnosis of internal carotid pseudoaneurysm. Cerebral angiogram showed dissection of internal carotid artery with a large pseudoaneurysm and almost complete occlusion of vessel distal to aneurysm. Vessel was obliterated by fibercoiling and gluing by endovascular technique to diminish risk of further embolization. MRI characteristics of carotid pseudoaneurysms and role of endovascular treatment are discussed.