a1 School of Dental Sciences, Newcastle University, UK
a2 Otolaryngology and Head and Neck Surgery Department, Newcastle upon Tyne NHS Foundation Trust, UK
a3 Newcastle Dental Hospital, Newcastle upon Tyne NHS Foundation Trust, UK
Objectives: We report a case of an internal carotid artery aneurysm presenting as orofacial pain.
Method: Case report and discussion.
Results: A 59-year-old patient presented with a four-year history of chronic oral pain accompanied by a right-sided occipital headache. No local organic pathology was detected, and a provisional diagnosis of persistent idiopathic facial pain was made. A neurosurgery referral was made to exclude neurovascular pathology, which resulted in the detection of an aneurysm originating from the right posterior communicating artery. This was successfully treated by coil embolisation, with subsequent resolution of symptoms.
Conclusion: In this patient, an atypical history of pain with no other neurological signs or symptoms, other than accompanying occipital headache, led to the discovery of an intracranial aneurysm. This case highlights the need for appropriate referral and imaging in cases in which the clinical history and findings are not classical, and also emphasises the need for interdisciplinary management.
(Accepted October 05 2011)
(Online publication May 29 2012)
Mr S Stone takes responsibility for the integrity of the content of the paper
Competing interests: None declared