Cavernous carotid aneurysm presenting with epistaxis.
BACKGROUND
Carotid artery aneurysms are a rare cause of epistaxis. The most common presentation for nontraumatic cavernous internal carotid artery aneurysms is mass effect, with only 3% presenting with hemorrhage. We present a case of epistaxis caused by a nontraumatic cavernous internal carotid artery aneurysm.


METHODS
A 73-year-old white woman was seen with a 1-month history of recurrent right-sided epistaxis. The patient had essential hypertension and a family history of intracranial aneurysm. A complete otolaryngologic, neurologic, and ophthalmologic examinations were normal. Contrast-enhanced CT of the paranasal sinuses revealed a trilobed aneurysm of the cavernous segment of the right internal carotid artery. Coil embolization of the cavernous aneurysm and right internal artery was performed.


RESULTS
The patient has had no further episodes of epistaxis and has remained neurologically intact.


CONCLUSIONS
Carotid artery aneurysms must be considered in the differential diagnosis of profuse epistaxis.
Department of Otolaryngology, The Mount Sinai Medical Center, Box 1189, One Gustave L. Levy Place, New York, NY, 10029-3136, USA.
Houtan
H
Chaboki
Aman B
AB
Patel
Stephen
S
Freifeld
Mark L
ML
Urken
Peter M
PM
Som
D000368:Aged; D000783:Aneurysm / Q000150:complications* / Q000000981:diagnostic imaging / Q000628:therapy; D002340:Carotid Artery Diseases / Q000150:complications* / Q000000981:diagnostic imaging / Q000628:therapy; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging; D003937:Diagnosis, Differential; D004621:Embolization, Therapeutic / Q000379:methods; D004844:Epistaxis / Q000209:etiology* / Q000628:therapy; D005260:Female; D006801:Humans; D012008:Recurrence; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome