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Massive Epistaxis due to Traumatic Internal Carotid Artery Pseudoaneurysm:A Case Report Kenta FUJIMOTO 1 , Hiroyuki HASHIMOTO 1 , Taiji YONEZAWA 1 , Katsuya MASUI 1 , Noriyuki NISHI 1 , Hisashi IKEUCHI 2 , Shozo KAWAI 1 1Department of Neurosurgery, Osaka General Medical Center 2Department of Emergency and Critical Care, Osaka General Medical Center Keyword: traumatic pseudoaneurysm , internal carotid artery , epistaxis , endovascular treatment pp.339-343
Published Date 2008/4/10
DOI https://doi.org/10.11477/mf.1436100723

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  • Abstract
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 We present a case of traumatic pseudoaneurysm of the internal carotid artery (ICA) accompanied by skull base fracture, which was treated by endovascular trapping of the internal carotid artery. A 70-year-old woman met with a traffic accident and was admitted to our institution with epistaxis and accomapanied with shock. Angiography on day 2 showed carotid-cavernous fistula. The patient had no eye symptom and was treated conservatively. A second angiography, two weeks aftrer the trauma, revealed development of a pseudoaneurysm on the C3-4 portion. We attempted balloon test occlusion (BTO) of the right internal carotid artery, and if torelated, the ICA may have been occluded. The day before BTO, she rebleed massively. Endovascular trapping of the ICA was performed. Although epistaxis was controlled completely, she suffered left hemiparesis due to an embolism during the procedure. Epistaxis from a traumatic aneurysm of the internal carotid artery may be fatal and emergency occlusion is proposed.


Copyright © 2008, Igaku-Shoin Ltd. All rights reserved.

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

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