A rare combination of carotid artery congenital abnormalities: understanding the embryology and clinical associations

Duplication of an extracranial internal carotid artery, a retropharyngeal carotid transposition, an aberrant internal carotid artery in the middle ear, and a persistent stapedial artery are each individually uncommon vascular variants. In this case report, we discuss a rare occurrence of all four of these variants in a single individual who presented to our emergency department with a complaint of dizziness and a recent fall. Included in the discussion is pertinent embryology and clinical associations.