Delayed massive epistaxis from traumatic cavernous carotid false aneurysms: A report of two unusual cases

作者：Mankahla Ncedile^*; LeFeuvre David; Taylor Allan

来源：Interventional Neuroradiology, 2017, 23(4): 387-391.

DOI：10.1177/1591019917706053

• Cerebrovascular trauma
• aneurysm
• carotid
• epistaxis

Introduction: Blunt head trauma can injure the cavernous segment of the internal carotid artery (ICA). This may result in a carotid cavernous fistula (CCF). Rarely, a traumatic aneurysm may bleed medially causing massive epistaxis.
Case presentation: We present two cases of traumatic intracavernous carotid pseudoaneurysms with delayed massive epistaxis. The patients were managed with endovascular treatment involving coil embolization with parent vessel sparing and detachable balloon occlusion with carotid sacrifice. Early clinical outcome was good in both patients. Wherever possible, the CARE 1 guidelines were followed in the reporting.
Conclusion: These cases illustrate the delayed nature of traumatic aneurysms and the need for a high index of suspicion in the presence of skull base fractures. The use of endovascular detachable balloon occlusion and coil embolization treatment with parent vessel preservation is shown.

• 出版日期2017-8