Internal carotid artery(ICA) compression by an aneurysm itself is rare. A case of the stenosis of the ophthalmic segment of the left internal carotid artery by pressure exerted on the artery by a ruptured large anterior communicating artery(AcoA) aneurysm is reported. A 43-year-old woman was referred to our hospital with sudden severe headaches, two attacks of general tonic-clonic seizure, followed by severe mental change and hemiparesis. Cerebral angiogram revealed a large aneurysm projecting inferolaterally, resulting in compression of the left ICA. Clipping the aneurysm was uncomplicated and over time, the patient recovered progressively, though mild right hemiparesis and motor dysphasia still remained at six-month follow-up. We believe that cerebral ischemia and hypoxia following repeated seizure in the stenotic ICA may have played a major role in the prolonged hemiparesis and motor dysphasia seen in this case.