[Massive epistaxis due to traumatic internal carotid artery pseudoaneurysm: a case report].
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 carotidcavernous 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.
Fujimoto
Kenta
K
Department of Neurosurgery, Osaka General Medical Center, 3-1-56 Bandai-Higashi, Sumiyoshi-ku, Osaka 558-8558, Japan.
Hashimoto
Hiroyuki
H
Yonezawa
Taiji
T
Masui
Katsuya
K
Nishi
Noriyuki
N
Ikeuchi
Hisashi
H
Kawai
Shozo
S
D000368:Aged; D020212:Carotid Artery Injuries / Q000209:etiology*; D002343:Carotid Artery, Internal; D004621:Embolization, Therapeutic / Q000379:methods*; D004844:Epistaxis / Q000209:etiology* / Q000628:therapy*; D005260:Female; D016489:Head Injuries, Closed / Q000150:complications*; D006801:Humans; D019291:Skull Base / Q000293:injuries*; D016896:Treatment Outcome