A mycotic aneurysm of the intracavernous carotid artery developed following a parapharyngeal abscess in a 55-year-old woman. The patient was admitted to our hospital with a 10-day history of trismus and a 1-day history of low-grade motor aphasia. Her upper left first molar had been extracted by a dentist 4 weeks previously. On the second hospital day, surgical drainage was performed. Despite apparent clinical improvement, total ophthalmoplegia developed suddenly on the 6th hospital day. An aneurysm of the left intracavernous carotid artery was seen on MRI and carotid angiography. It was treated medically. Ophthalmoplegia gradually improved. Our review of the literature revealed no other reports of mycotic carotid aneurysm caused by parapharyngeal abscess.
