Facial paralysis as the initial presentation of an internal carotid artery aneurysm

Aneurysms of the intrapetrous internal carotid artery are rarely encountered and can present difficult diagnostic problems. A review of the literature revealed 34 cases, and we now add a 35th. Presenting symptoms and signs are dependent on the direction of expansion of the aneurysm, with neurologic dysfunction typical of medial expansion, whereas lateral erosion often suggests a glomus tumor.