Ischaemic stroke and intracranial haemorrhage from an internal carotid artery aneurysm: a management dilemma

Internal carotid artery aneurysms (ICAAs) are rare and predominantly affect older females. Though often asymptomatic, larger ICAAs may cause compressive symptoms, thromboembolism, ischaemic stroke, transient ischaemic attacks (TIA), or massive bleeding upon rupture. The prevalence of ischaemic stroke or TIA in ICAA patients ranges from 3-6.3%. Contributing factors include congenital conditions, trauma, cranial surgeries, radiation, and infections. We report a 42-year-old woman with an acute frontal lobe infarction due to an ICAA, which subsequently led to fatal intracranial haemorrhage. Early diagnosis and timely intervention are critical to reduce the mortality and morbidity associated with ICAAs and their complications.