Internal carotid artery (ICA) aneurysm is rare. The authors describe a seventy-three-year-old woman whose chief complaint was a pulsatile left laterocervical mass, increasing in size over a five-year-period. Duplex scanning, computed tomography, and digital subtraction angiography disclosed a 4-cm aneurysm of the ICA. Surgical resection was performed, and an end-to-end anastomosis between the proximal and distal ICA was created. The patient made an uneventful recovery.
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