Abstract
An asymptomatic 33 year old male Air Combat Officer was recommended to have a CT cerebral angiogram, based on a family history of a vascular anomaly. A 1-2mm aneurysm located in the cavernous portion of the internal carotid artery was discovered. Neurosurgical advice was obtained which indicated that the risk of haemorrhage from this aneurysm in this location is ‘practically zero’, and that there is no indication for any intervention. The fast jet environment does impose significant stress on the individual however, and aeromedical decision making is often more difficult when, despite the depth of evidence available, the risks remain unquantifiable. This paper discusses the literature review conducted, the risk factors for rupture and risks of rupture, precipitating events, treatment, monitoring, and advice for the affected individual. The aeromedical disposition of the affected individual is outlined.