36-year old woman, s/p motor vehicle collision. On admission, an angiogram demonstrated a pseudoaneurysm of the thoracic aorta, as well as a grade 3 (pseudoaneurysm) of her left internal carotid artery. Her aorta was repaired immediately; on follow-up angiography of her carotid injury, her pseudoaneurysm had progressed and there was significant narrowing of the adjacent internal carotid artery. Digital subtraction angiogram of the left internal carotid artery, 7-days following initial injury. There is a pseudoaneurysm (arrow) of the proximal internal carotid artery with narrowing of the adjacent artery. A second, smaller pseudoaneurysm (arrowhead) is noted in the more distal artery.