Bilateral Extracranial Carotid Artery Aneurysms Presenting with Acute Cerebral Infarction

Extracranial carotid artery aneurysm (ECCA) is an uncommon cause of embolic stroke. Patients with ECCA present with a variety of clinical symptoms. Careful inspection of the skull base of cross-sectional brain computed tomography (CT) is important for screening high cervical ECCAs. Further cervical magnetic resonance (MR) angiography or CT angiography is necessary to confirm the final diagnosis. Treatment options include open surgery, endovascular intervention, or medical management. Here, we report the case of a patient with bilateral atherosclerotic ECCAs who presented with acute cerebral infarction. The cause of stroke was documented as artery-to-artery emboli from a giant aneurysm of the left high cervical internal carotid artery (ICA).