Massive epistaxis resulting from an intracavernous internal carotid artery traumatic pseudoaneurysm: complete resolution with overlapping uncovered stents

2009 ◽  
Vol 151 (12) ◽  
pp. 1681-1684 ◽  
Author(s):  
Fernando Ruiz-Juretschke ◽  
Enrique Castro ◽  
Olga Mateo Sierra ◽  
Begoña Iza ◽  
Jose Manuel Garbizu ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Complete Resolution ◽  
Internal Carotid ◽  
Uncovered Stents ◽  
Traumatic Pseudoaneurysm

scholarly journals Flow-diverter stenting in post-traumatic pseudoaneurysm of cavernous internal carotid artery with epistaxis

2015 ◽  
Vol 21 (3) ◽  
pp. 325-328 ◽  
Author(s):  
Andrea Giorgianni ◽  
Carlo Pellegrino ◽  
Renzo Minotto ◽  
Anna Mercuri ◽  
Fabio Baruzzi ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Flow Diverter ◽  
Left Internal Carotid Artery ◽  
Sphenoidal Sinus ◽  
Occlusion Test ◽  
Flow Diverter Stent ◽  
Traumatic Pseudoaneurysm ◽  
Post Traumatic

This paper is a case report of a young patient after a major head trauma causing multiple skull base fractures. The trauma occasioned pseudoaneurysm (PSA) from intracavernous C4 segment of left internal carotid artery (ICA) protruding in the sphenoidal sinus. After two months, two episodes of massive epistaxis occurred. Consequently, the post-traumatic PSA was treated, after carotid occlusion test, with flow-diverter stent positioning. A computed tomography angiography study performed in the following days showed complete resolution of the post-traumatic PSA lesion and ICA patency.

scholarly journals Efficacy of Endovascular Surgery for Unruptured Internal Carotid Artery Aneurysms Presenting with Cranial Nerve Symptoms

2007 ◽  
Vol 13 (1_suppl) ◽  
pp. 163-169 ◽  
Author(s):  
S. Suzuki ◽  
A. Kurata ◽  
S. Kan ◽  
M. Yamada ◽  
J. Niki ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Cranial Nerve ◽  
Cranial Nerve Palsy ◽  
Complete Resolution ◽  
Nerve Palsy ◽  
Internal Carotid ◽  
Endovascular Surgery ◽  
Detachable Coils ◽  
The Mean

Whether endovascular surgery is able to reduce the mass effects of unruptured aneurysms is still controversial, although some reports have suggested efficacy in cases of internal carotid artery aneurysms with cranial nerve palsy. Here we assessed outcome in a series of cases. Between April 1992 and April 2005, 18 patients with unruptured internal carotid artery aneurysms presenting with cranial nerve palsy were treated by endovascular surgery. The patients were two males and 16 females aged from 19 to 84 (mean 59.6 years). Aneurysms were located in the cavernous portion in 14, at the origin of the ophthalmic artery in one and at the origin of P-com in three. The aneurysms were all embolized using Guglielmi detachable coils, Interlocking detachable coils, Cook's detachable coils or Trufill DSC and detachable Balloons were applied to occlude the proximal parent artery. We analyzed the efficacy of endovascular surgery for such aneurysms retrospectively. The mean aneurysm size was 21.4 mm and the mean follow-up period was 57.7 months. Palsy of IInd cranial nerve was evident in three patients, of the IIIrd in eight, of the Vth and Vth in one each, and of the VIth in nine. Post embolization occlusion was complete in nine patients and neck remnant in the other seven. Regarding complications of endovascular surgery, one case (5.6%) showed TIA after embolization. Overall 11 (46%) cranial nerve symptoms showed complete resolution, eight (33%) showed some improvement, and five (21%) were unchanged. In three cases (12.5%), the symptoms worsened after treatment. The shorter the duration of symptoms was a factor predisposing to resolution of symptoms. In complete resolution cases, the timing of treatment after symptoms appeared and the time of complete resolution were in proportion. These results showed that there is no difference in reduction of mass effects between surgical clipping and endovascular surgery for unruptured internal carotid artery aneurysms. With endovascular surgery, the rapidity of treatment after symptoms is the most important factor for successful results.

scholarly journals Traumatic Pseudoaneurysm of Internal Carotid Artery presenting as Intractable Epistaxis in a Case of Maxillary Fracture

2015 ◽  
Vol 49 (1) ◽  
pp. 49-51
Author(s):  
Vidya Rattan ◽  
Dinesh Kumar ◽  
Gyana Ranjan Sahu ◽  
KK Mukherjee
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Rare Complication ◽  
Facial Trauma ◽  
Artery Pseudoaneurysm ◽  
Recurrent Epistaxis ◽  
Traumatic Pseudoaneurysm ◽  
Maxillary Fracture ◽  
Intractable Epistaxis

ABSTRACT Traumatic pseudoaneurysm of internal carotid artery is a rare complication of injury after craniomaxillofacial trauma. Delayed recurrent epistaxis after head and facial trauma is the most distinctive manifestation of traumatic internal carotid artery pseudoaneurysm. Epistaxis due to pseudoaneurysm of internal carotid artery is difficult to control, and may lead to hemor- rhagic shock or asphyxia and thus seriously threatens life. The purpose of this paper is to present a rare case of recurrent epistaxis secondary to ICA pseudoaneurysm following blunt maxillofacial trauma. Endovascular stenting was performed and the recurrent epistaxis was successfully arrested. How to cite this article Kumar D, Sahu GR, Kumar A, Mukherjee KK, Rattan V. Traumatic Pseudoaneurysm of Internal Carotid Artery presenting as Intractable Epistaxis in a Case of Maxillary Fracture. J Postgrad Med Edu Res 2015;49(1):49-51.

Traumatic Pseudoaneurysm of the Cervical Carotid Artery: The Value of Arteriography

Neurosurgery ◽  
1990 ◽  
Vol 26 (2) ◽  
pp. 312-315 ◽  
Author(s):  
Laura Jones Applegate ◽  
Michael B. Pritz ◽  
Henry F. W. Pribram
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Gunshot Wound ◽  
Internal Carotid ◽  
Penetrating Injuries ◽  
Complete Occlusion ◽  
Traumatic Lesions ◽  
Distal Internal Carotid Artery ◽  
Initial Injury ◽  
Traumatic Pseudoaneurysm

Abstract A patient who sustained a gunshot wound to the neck and subsequent blunt trauma is presented. No angiogram was performed after the initial injury. Subsequently, the patient developed a cerebral embolus from a thrombus dislodged from a pseudoaneurysm of the cervical carotid artery, resulting in complete occlusion of the distal internal carotid artery. After antiplatelet therapy, the distal internal carotid artery recanalized. and the pseudoaneurysm occluded spontaneously. We stress the need for the use of arteriography in the initial evaluation of penetrating injuries to the neck and the utility of repeated arteriograms for further treatment planning as these traumatic lesions can change with time.

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