Traumatic intracavernous aneurysm in children: massive epistaxis without ophthalmic signs

Traumatic intracavernous aneurysms are a distinctly uncommon lesion in children. They usually present with compressive symptoms of the III, IV, V, or VI cranial nerves rather than epistaxis. Epistaxis is rare and usually minor and brief in duration. A child with severe head injury and basal skull fracture, who did not have any preceding symptoms or signs of ophthalmoplegia or exophthalmus, developed massive epistaxis as a leading symptom of the ruptured intracavernous aneurysm. Since there are no reported pediatric cases with fatal epistaxis as a presenting sign, we would like to share our experience.