Bilateral internal carotid artery aneurysms with diffuse intracranial calcification: report of one case

A 15-year-old girl with voice hoarseness and neck soreness for 4 months had a pulsating mass, sized 3 x 5 cm, adjacent to the right mastoid process. Physical examination revealed normal blood pressure recordings in 4 limbs and no stigmata of Marfan syndrome. Examination of the oral cavity showed bulging of the right pharyngeal wall medially, and the tongue deviated to the right at protrusion. Laboratory workups including complete blood counts, biochemistry, electrolytes, serological and immunological surveys revealed nothing particular. Echocardiography disclosed mild aortic dilatation. Computed tomography of the head and neck revealed bilateral carotid aneurysms with extensive intracranial calcification. The saccular aneurysm over the left internal carotid artery was resected, and end-to-end anastomosis of the left internal carotid artery was performed. The giant occluded right carotid aneurysm was left unmanaged. The combination of bilateral carotid aneurysms and intracranial calcification has not been reported. The etiologies are discussed and a causal relationship between these two conditions is postulated.