Embolic stroke from common carotid pseudo-aneurysm.

A 52-year-old man presented with signs of a right middle cerebral artery stroke. A large pulsatile mass was noted at the right base of his neck, together with an overlying scar which the patient reported as being due to a stab wound sustained 22 years ago (Fig. 1). A computed tomography (CT) scan of the brain showed an infarct in the area of the right middle cerebral artery (Fig. 2). Computed tomographic angiography revealed a pseudo-aneurysm of the right common carotid artery at its origin with extensive surrounding thrombus (Fig. 3), as well as paucity of branches of the right middle cerebral artery (Fig. 4). Definitive management of the pseudoaneurysm was achieved by vascular surgical intervention.