Aberrant right internal carotid artery

Case contributed by Dr Jeffrey Hocking

Presentation

Pulsatile tinnitus

Patient Data

Age: 25 years
Gender: Female

There is an aberrant right ICA, which enters the skull base through an enlarged inferior tympanic canaliculus just in front of the jugular bulb.This then courses anteriorly along the chochlear promontory in a typical fashion to join the petrous ICA.There is a relative narrowing as it turns forward in the tympanic canaliculus. The aberrant ICA bulges up into the hypotympanum, and abuts /bulges the inferior eardrum outward. It also abuts the malleus insertion.

There is an associated aberrant stapedius artery which enlarges the anterior portion of the (tympanic) facial canal.

There is an aberant right ICA, which enters the skull base through an enlarged inferior tympanic canaliculus just in front of the jugular bulb.This then courses anteriorly along the chochlear promontory in a typical fashion to join the petrous ICA.There is a relative narrowing as it turns forward in the tympanic canaliculus. The aberrant ICA bulges up into the hypotympanum, and abuts /bulges the inferior eardrum outward. It also abuts the malleus insertion.

There is an associated aberrant stapedius artery which enlarges the anterior portion of the (tympanic) facial canal.
 

Case Discussion

Aberrant internal carotid arteries are a potential cause for pulsatile tinnitus. It forms due to a collateral pathway that occurs as a result of agenesis of the first embryonic segment of the ICA 1.

Although rare, misdiagnosis can result in severe morbidity and mortality, particularly during otologic procedures.

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Case information

rID: 65191
Published: 28th Dec 2018
Last edited: 28th Dec 2018
Inclusion in quiz mode: Included

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