title: Internal Carotid Artery Aneurysms Presenting with Epistaxis - Our Experience and Review of Literature.
abstract: OBJECTIVE
  Intracranial internal carotid artery aneurysms are an extremely rare cause of spontaneous epistaxis, with a few documented cases. The management of such cases is challenging due to the relative anatomical inaccessibility of the bleeding point. The aim of the present study was to acquaint the readers with this rare type of aneurysm presenting with epistaxis and to report our experience of treating cases of severe epistaxis due to internal carotid artery (ICA) aneurysms.
  
  
  METHODS
  Data of 4 patients with İCA aneurysms presenting with epistaxis from June 2011 to July 2013 was retrospectively reviewed.
  
  
  RESULTS
  The age of patients ranged from 16 to 62 years. Duration of epistaxis ranged from 3 months to 3 years. Two patients had severe epistaxis following transnasal biopsy. Two patients had a history of trauma. Two patients developed hemodynamically instability. All the patients were managed with trapping of the aneurysm. Complete exclusion of aneurysm from circulation was achieved in all the patients.
  
  
  CONCLUSIONS
  ICA aneurysms can rarely present as life-endangering epistaxis. In patients presenting with a history of craniocerebral trauma, traumatic pseudoaneurysm must be considered as a differential diagnosis. Trapping of the aneurysm is a good option if there is good cross circulation.
authors.affiliation: All India Institute of Medical Sciences, Department of Neurosurgery, New Delhi, India.
authors.forename: Kanwaljeet
authors.initials: K
authors.lastname: Garg
authors.forename: Hitesh Kumar
authors.initials: HK
authors.lastname: Gurjar
authors.forename: Pankaj Kumar
authors.initials: PK
authors.lastname: Singh
authors.forename: Manmohan
authors.initials: M
authors.lastname: Singh
authors.forename: P Sarat
authors.initials: PS
authors.lastname: Chandra
authors.forename: Bhawani Shankar
authors.initials: BS
authors.lastname: Sharma
mesh_terms: D000293:Adolescent; D000328:Adult; D000783:Aneurysm / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*; D002340:Carotid Artery Diseases / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*; D003937:Diagnosis, Differential; D004844:Epistaxis / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies