Bilateral aberrant internal carotid arteries: treatment of a hemorrhagic complication

The aberrant internal carotid artery is a rare congenital abnormality that may present with pulsatile hemorrhage if undiagnosed before surgical intervention in the middle ear. We present such a patient who was treated successfully with endovascular sacrifice of one of her bilateral lesions after recurrent episodes of pulsatile hemorrhage complicating multiple tympanostomy tube revisions.