Abstract
This systematic review aims to describe the anatomical variations of the internal carotid artery (ICA) and their implications for clinical practice and surgical planning. The ICA, a major vessel supplying the brain, exhibits considerable anatomical variability that can impact the safety and efficacy of procedures involving the neck region and skull base. A comprehensive search of eight databases from 2015 to 2024 yielded 379 studies, of which eight met the inclusion criteria. The reviewed studies reported common variations such as tortuosity, protrusion into the sphenoid sinus, congenital anomalies, and bony dehiscence. These findings underscore the importance of detailed preoperative imaging and thorough anatomical knowledge to reduce surgical risks and improve patient outcomes. Recognition of ICA variants remains essential for planning and performing safe and effective surgical interventions.