ISOLATED CRANIAL NERVE VI PALSY DUE TO A GIANT INTERNAL CAROTID ARTERY ANEURYSM: A CASE REPORT

Giant intracranial aneurysms are rare, with those loca­ted in the petrous segment of the internal carotid ar­tery being even less common. These aneurysms may cause neurological deficits due to mass effect on adjacent structures, especially cranial nerves. We present a case of a 60-year-old woman with persistent headaches and binocular diplopia. Neurological examination revealed isolated left abducens nerve palsy. Imaging identified a 25 mm partially thrombosed saccular aneurysm at the lacerum-cavernous segment of the left internal carotid artery. Given the symptomatic presentation and risk of progression, the patient underwent successful endovas­cular embolization with a flow-diverter stent and coils, resulting in marked symptom improvement. This case highlights the importance of considering internal carotid artery aneurysms in patients with cranial nerve palsies. Early imaging and timely endovascular intervention can prevent irreversible neurological damage and signifi­cantly improve clinical outcomes.