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Traumatic Anterior Cerebral Artery Pseudoaneurysmal Epistaxis
Qing Lin Liu1, Hao Xue1, Chang Jing Qi2
1Neurosurgery Department, Qilu Hospital of Shandong University, Jinan, China.
World Neurosurgery
|December 13, 2016
Summary
Pseudoaneurysmal epistaxis, a rare condition, can arise from the anterior cerebral artery. Endovascular treatment is effective but has a high recurrence rate, necessitating alternative options like surgery.
Area of Science:
- Neurology
- Vascular Surgery
- Interventional Radiology
Background:
- Pseudoaneurysmal epistaxis is a rare and emergent clinical presentation.
- Traumatic head injuries can lead to complex vascular complications.
Observation:
- A case of a 49-year-old male with severe head trauma presented with recurrent epistaxis.
- Digital subtraction angiography revealed an anterior cerebral artery pseudoaneurysm protruding into the posterior ethmoid sinus.
Findings:
- Initial endovascular embolization with microcoils resulted in parent artery occlusion.
- Recanalization and aneurysm recurrence occurred, requiring a second embolization with coils and Onyx.
- This is the first reported case of anterior cerebral artery pseudoaneurysm presenting as epistaxis.
Implications:
- Endovascular intervention is the primary treatment for pseudoaneurysmal epistaxis.
- High recurrence rates are a significant drawback of endovascular approaches.
- Aneurysm trapping with bypass surgery presents an alternative treatment strategy.
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