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An aberrant internal carotid artery (ICA) is a rare vascular anomaly that is thought to develop from early agenesis of the first embryonic segment of the ICA and compensatory hypertrophy of the inferior tympanic branch of the ascending pharyngeal artery and the caroticotympanic branch of the ICA. Although this anomaly, which mimics a middle ear mass, is often reported as causing pulsatile tinnitus or ear bleeding following traumatic injury due to myringotomy or other surgical procedures, no case of aberrant ICA with spontaneous massive bleeding has been previously reported. Furthermore, infectious pseudoaneurysm (i-pseudoaneurysm) associated with aberrant ICA is extremely rare, and an optimal treatment strategy has not yet been established.

Ruptured aberrant internal carotid artery pseudoaneurysm presenting with spontaneous massive ear bleeding following a single sneeze: a case report