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Related Experiment Video

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Inducing Post-Traumatic Epilepsy in a Mouse Model of Repetitive Diffuse Traumatic Brain Injury
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Post-traumatic Cavernous Carotid Pseudoaneurysm with Delayed Epistaxis.

Girish Menon1, Ajay Hegde1, Rajesh Nair1

  • 1Neurosurgery, Kasturba Medical College, Manipal, IND.

Cureus
|September 26, 2018
PubMed
Summary

Delayed epistaxis can signal a rare cavernous carotid aneurysm (CCA). A young adult with a head injury presented with blindness, orbital fractures, and severe nosebleeds, successfully treated with carotid artery ligation and bypass surgery.

Keywords:
cavernous carotid aneurysmcerebrovascular bypassec-ic bypassepistaxis

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Area of Science:

  • Neuroscience
  • Vascular Surgery

Background:

  • Cavernous carotid aneurysms (CCAs) present complex management challenges.
  • Delayed post-traumatic epistaxis is an uncommon yet critical manifestation of CCAs.

Observation:

  • A symptomatic triad of unilateral blindness, orbital fractures, and massive epistaxis is pathognomonic for internal carotid artery (ICA) pseudoaneurysm.
  • This condition, often presenting as life-threatening epistaxis due to pseudoaneurysm rupture through the sphenoid sinus, requires high clinical suspicion for early diagnosis.

Findings:

  • A case report details a young adult with severe anemia and the classic triad four months post-head injury.
  • The patient underwent successful treatment via carotid artery ligation and high-flow extracranial-intracranial (EC-IC) bypass.

Implications:

  • This case underscores the importance of considering CCAs in patients with traumatic head injuries and epistaxis.
  • Extracranial-intracranial (EC-IC) bypass remains a viable and effective treatment option for complex giant aneurysms, even with advancements in endovascular techniques.