Cervical carotid aneurysm presenting as transient ischemia and recurrent laryngeal nerve palsy

Aneurysms of the extracranial carotid artery are rare. Neurological manifestations in patients with these lesions may be quite varied. This paper presents a unique patient who showed both hoarseness due to left recurrent laryngeal nerve paralysis as a local sign of compression, and ischemic syncopal attack as an embolic or flow-related symptom. Little has appeared in the otolaryngologic literature, despite the fact that many patients have symptoms that may initially lead them to see an otolaryngologist. A misleading needle biopsy of the mass in the neck was performed by a local otolaryngologist before the diagnosis was confirmed. The literature on the subject is briefly reviewed.