Abstract
A review of 108 years of world literature revealed 69 cases fulfilling the picture of a clinical syndrome of head injury, a latent period followed by epistaxis and cranial nerve lesions. A similar case has been added which is the fourth case to be reported to be due to a bullet injury. The applied anatomy of the intracranial internal carotid artery (ICA) and the aetiology, clinical syndrome, pathology, diagnosis, prognosis and management of ICA aneurysms have been briefly discussed.