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This 50 year old housewife reported with severe right sided orbital and temporal pain. The clinical examination revealed right third cranial nerve paresis with ptosis and small sized pupil, (Reader's syndrome - Group I). Cerebral angiogrpahy revealed a giant, partially thrombosed aneurysm of the right internal carotid artery. Her facial pain was relieved by carotid ligation. Intracranial internal carotid aneurysms rarely cause paratrigeminal syndrome of Raeder. The mechanism of facial pain and ocular synpathetic involvement is discussed.