Spontaneous common carotid artery pseudoaneurysm (CCAP) is rare but potentially lethal disease. A 78-year-old man presented with pain in correspondence of right neck side and slight right eye ptosis. No previous surgery, trauma, or venous catheterizations in the neck region were reported. The computed tomographic angiography (CTA) showed a 4-cm saccular CCAP. The patient was managed emergently with surgical CCAP excision. At 6-month follow-up, the patient is neck pain-free with complete ptosis regression, and the CTA shows no pathologic findings. The literature review reported 7 cases of pseudoaneurysm of carotid district. All these cases were managed by surgical approach, and in 1 case, an endovascular embolization procedure was associated before. The CTA was used in all cases but angiography in only one. In these cases, the surgical repair with pseudoaneurysm evacuation is still the treatment of choice.
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