[Villaret's syndrome due to extra-cranial internal carotid aneurysm: a case report]

A 69 year-old male was admitted to our clinic with the chief complaint of hoarseness and difficulty in swallowing. These symptoms occurred about 5 months after penetrating neck injury. Neurological examination revealed right ninth to twelfth cranial nerves palsy and Horner's syndrome. Plain skull X-P demonstrated two broken pieces of glass below the right mastoid processus. The right carotid angiogram showed a 45 x 25 mm aneurysm originated from the right internal carotid artery just below the carotid canal. As the first operation, gradual occlusion of right internal carotid artery combined with the right STA-MCA anastomosis was performed. But two days after complete occlusion, left hemiparesis and pseudobulbar palsy appeared. Two months after such episode, aneurysm and the pieces of glass were removed. He discharged on foot with the improvement of the symptoms of lower cranial nerves. Villaret's syndrome caused by the traumatic aneurysm of extracranial internal carotid artery is rare. This case seems to be the first report in Japan.