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Dissecting Internal Carotid Aneurysm Causing Epistaxis:A Case Report Hiroyoshi KINO 1 , Wataro TSURUTA 2 , Yoshiro ITO 1 , Tomoji TAKIGAWA 1 , Masanari SHIIGAI 3 , Aiki MARUSHIMA 1 , Yasunobu NAKAI 4 , Tetsuya YAMAMOTO 1 , Akira MATSUMURA 1 1Department of Neurosurgery, University of Tsukuba 2Department of Endovascular Neurosurgery, Toranomon Hospital 3Department of Radiology, Tsukuba Medical Center Hospital 4Department of Neurosurgery, Tsukuba Medical Center Hospital Keyword: ruptured aneurysm , epistaxis , internal carotid artery , Onodi cell pp.789-795
Published Date 2018/9/10
DOI https://doi.org/10.11477/mf.1436203815
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 We report a rare case of a ruptured dissecting internal carotid aneurysm caused epistaxis without a history of trauma or infection. An 89-year-old woman experienced epistaxis and suffered from hemorrhagic shock at her previous hospital. Head computed tomography(CT)images revealed a ruptured internal carotid aneurysm protruding into the Onodi cell, the most posterior ethmoidal sinus, which extends superolaterally to the sphenoid sinus. Cerebral angiography demonstrated a multilobular-shaped dissecting aneurysm with a maximal diameter of 6.7mm at the cavernous portion of the internal carotid artery(ICA). Overlapping stenting was performed to prevent recanalization. However, a fatal subarachnoid hemorrhage occurred 2 days after the procedure due to the progression of the dissection to the intracranial ICA. The anatomical characteristics of the ethmoidal sinus could be associated with the occurrence of epistaxis. A ruptured small ICA aneurysm with an Onodi cell might cause epistaxis without a history of trauma or infection.


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電子版ISSN 1882-1251 印刷版ISSN 0301-2603 医学書院

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