Internal carotid artery pseudoaneurysm presenting as a peritonsillar abscess

Carotid artery pseudoaneurysms are a rare pediatric entity and typically present with bleeding, nerve involvement due to impingement, or as a pulsatile neck mass. We present a 14-year-old male with a history of recent orthodontic placement, who exhibited persistent sore throat, headaches, recurrent emesis and physical exam findings suspicious for a peritonsillar abscess. However, CT scan demonstrated left internal carotid artery pseudoaneurysm. This case accentuates a unique presentation of an internal carotid artery pseudoaneurysm.