A previously healthy 25-year-old female was presented to the otorhinolaryngology outpatient clinic, complaining of painless progressive pulsatile swelling over the left side of the neck for 1 month. The patient gave a history of fine-needle aspiration cytology (FNAC) of left cervical lymph node a month ago at a peripheral hospital for reactive cervical lymphadenopathy. She noted the onset of swelling 2–3 days after the FNAC which progressively increased to the current size. Examination showed a fir m, non-tender, pulsatile swelling of size 10 x 8 cm over the left side of the neck (figure 1A), with visible pulsations and bruit on auscultation. Laryngoscopy showed a left lateral pharyngeal wall bulge without any airway compromise. MRI of the neck revealed a well-defined heterointense lesion noted arising from the left proximal internal carotid artery (ICA) displacing external carotid artery anteriorly and a peripheral T2 hyperintense thrombus with central flow voids likely an...
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