The aberrant internal carotid artery is a vascular anomaly of the temporal bone and occurs due to the agenesis of the first and second segments of the primitive internal carotid artery, resulting in dominance of a collateral pathway. The internal carotid artery provides the primitive brain its entire blood supply until the posterior circulation forms later in embryonic development. This condition is present in only 1% of the population and produces very subtle imaging findings potentially only discovered during middle ear surgery. During surgery, surgeons may misinterpret it for a glomus tumor or mass, and injury to the site can result in profuse bleeding and even death. Therefore, it is vital for physicians to have knowledge of this disease. Since radiologists are often the ones who diagnose this condition, we present a case report and detailed embryology and review anomalies of the internal carotid artery development.
Cite this article as: Rajesh R, Bosse B, Higley R, Babu J, Raghuram K, Rangaswamy R. Aberrant internal carotid artery: An unusual anatomic variant. Imaging Interv. 2022;2(2):19-22.