The clinical syndrome produced by an aneurysm at, or near, the junction of the internal carotid artery with the circle of Willis has recently been emphasized by Albright.1 He reviewed the thirty reported cases of aneurysm in this region and added two new cases.
Albright separated the cases into five etiologic groups. The most common etiologic factor was a congenital defect in the wall of the cerebral vessels. Next in order of frequency were atheromatous changes in the vessels, syphilis, posttraumatic aneurysms, resulting from fractures at the base of the skull, and mycotic aneurysms from infected emboli. He divided the symptoms into two groups: those due to involvement of the adjacent structures and those arising from leakage of blood from the aneurysm into the subarachnoid space. The most common symptoms were internal and external paralysis of the third nerve and involvement of the first branch of the fifth nerve.
Zollinger R, Cutler EC. ANEURYSM OF THE INTERNAL CAROTID ARTERYReport of a Case Simulating Tumor of the Pituitary. Arch NeurPsych. 1933;30(3):607-611. doi:10.1001/archneurpsyc.1933.02240150137008