title: Spontaneous rupture of an intra-cavernous internal carotid artery aneurysm presenting with massive epistaxis.
abstract: OBJECTIVE
  We report a rare case of epistaxis resulting from a ruptured internal carotid artery aneurysm, and present a successful treatment method.
  
  
  METHODS
  A 72-year-old woman was admitted following recurrent massive epistaxis. There was no history of trauma or surgery. Radiographic imaging demonstrated a large internal carotid artery aneurysm. An attempt was made to occlude the aneurysm with endovascular coils. Despite this, the patient went on to have further epistaxis. Endovascular ablation of the feeding internal carotid artery led to complete resolution.
  
  
  CONCLUSIONS
  This case demonstrates that spontaneous epistaxis from intra-cavernous carotid artery aneurysms can be managed using endovascular techniques. To our knowledge, we report the first use of interventional radiological techniques to assess the collateral circulation to the brain and subsequently undertake endovascular ablation of the internal carotid artery.
authors.affiliation: Department of Neurosurgery, Frenchay Hospital, Bristol, UK. alex.davies@doctors.org.uk
authors.forename: A
authors.initials: A
authors.lastname: Davies
authors.forename: O
authors.initials: O
authors.lastname: Dale
authors.forename: S
authors.initials: S
authors.lastname: Renowden
mesh_terms: D000368:Aged; D017542:Aneurysm, Ruptured / Q000150:complications / Q000000981:diagnostic imaging* / Q000628:therapy; D000792:Angiography; D002340:Carotid Artery Diseases / Q000150:complications / Q000000981:diagnostic imaging* / Q000628:therapy; D002343:Carotid Artery, Internal; D004621:Embolization, Therapeutic; D057510:Endovascular Procedures / Q000379:methods*; D004844:Epistaxis / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D005260:Female; D006801:Humans; D020896:Hypovolemia / Q000209:etiology; D002532:Intracranial Aneurysm / Q000150:complications / Q000000981:diagnostic imaging* / Q000628:therapy; D015642:Radiology, Interventional / Q000379:methods; D012008:Recurrence; D012422:Rupture, Spontaneous / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy; D015607:Stents