Internal carotid artery aneurysm presenting as orofacial pain.
OBJECTIVE
We report a case of an internal carotid artery aneurysm presenting as orofacial pain.


METHODS
Case report and discussion.


RESULTS
A 59-year-old patient presented with a four-year history of chronic oral pain accompanied by a right-sided occipital headache. No local organic pathology was detected, and a provisional diagnosis of persistent idiopathic facial pain was made. A neurosurgery referral was made to exclude neurovascular pathology, which resulted in the detection of an aneurysm originating from the right posterior communicating artery. This was successfully treated by coil embolisation, with subsequent resolution of symptoms.


CONCLUSIONS
In this patient, an atypical history of pain with no other neurological signs or symptoms, other than accompanying occipital headache, led to the discovery of an intracranial aneurysm. This case highlights the need for appropriate referral and imaging in cases in which the clinical history and findings are not classical, and also emphasises the need for interdisciplinary management.
School of Dental Sciences, Newcastle University, UK. simon.stone@newcastle.ac.uk
S J
SJ
Stone
V
V
Paleri
K S
KS
Staines
D002340:Carotid Artery Diseases / Q000150:complications / Q000175:diagnosis*; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging*; D003952:Diagnostic Imaging; D005157:Facial Pain / Q000209:etiology*; D005260:Female; D006261:Headache / Q000209:etiology*; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications / Q000175:diagnosis*; D008875:Middle Aged; D011859:Radiography; D014276:Trigeminal Nerve / Q000473:pathology