Pulsatile Neck Swelling: A High Riding Brachiocephalic Trunk with Retropharyngeal Internal Carotid Artery - Case Report

Anatomical variations in the branching of brachiocephalic trunk have been classified previously and similarly has been described the variations of the course of internal carotid artery including its retropharyngeal location; although their occurrence together is rare and seldom described. Here we report such a rare case of co-existing high riding brachiocephalic trunk presenting as anasymptomaticpulsatile antero-lateral neck swelling in a 55-year-old female detected using screening ultrasound with doppler examination and incidentally detected retropharyngeal right internal carotid artery diagnosed using contrast enhanced computed tomography of neck; Thus, highlighting the importance of screening and assessment of these variations in surgical procedures of neck due to surgical challenges and potential possibility of catastrophic bleeding associated with them.