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Posttraumatic pseudoaneurysm of the intracavernous internal carotid artery presenting with massive epistaxis

Patricia S Fontela1, Donatella Tampieri, Jeffrey D Atkinson

  • 1Division of Pediatric Critical Care, Montreal Children's Hospital, Montreal, Canada.

Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
|April 1, 2006
PubMed

Insights

Massive epistaxis can be a delayed complication of head injuries, caused by pseudoaneurysms in the internal carotid artery. Prompt diagnosis and endovascular treatment are crucial for managing this potentially lethal condition.

Area of Science:

  • Vascular Surgery
  • Neurotrauma
  • Endovascular Interventions

Background:

  • Posttraumatic pseudoaneurysms of the intracavernous internal carotid artery are rare but serious complications.
  • Massive epistaxis can be the presenting symptom, often with a delayed onset after head trauma.

Observation:

  • A pediatric patient developed massive epistaxis 12 days post-motor vehicle accident due to an intracavernous internal carotid artery pseudoaneurysm.
  • The pseudoaneurysm had dissected into the sphenoid sinus, as confirmed by angiography.

Findings:

  • Endovascular stent and coil occlusion successfully treated the pseudoaneurysm.
  • The patient recovered without ischemic or thromboembolic complications.

Implications:

  • This case highlights the importance of considering intracavernous carotid artery pseudoaneurysms in patients with head injuries and epistaxis.
  • Early diagnosis and intervention are critical to reduce the high mortality associated with this condition.
Abstract

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