scholarly journals Nasopharyngeal Coil Dislocation of an Embolized Internal Carotid Artery Pseudoaneurysm

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Nazli Ay ◽  
Ingo Todt ◽  
Holger Sudhoff

Objective. Severe epistaxis caused by ruptured intracranial pseudoaneurysms can be effectively treated by coil embolization. This is generally an efficient and safe procedure and provides sufficient protection recurrent epistaxis. However, complications such as aneurysm rupture, arterial dissection, bleeding, and emboli can occur. A dislocation of a nasopharyngeal coil is an extremely rare event. Patient. We present a case of a 61-year-old patient with a recurrent undifferentiated nasopharyngeal carcinoma (NPC) treated with severe epistaxis. Initially, epistaxis was successfully controlled by a nasal packing. Recurrent bleeding despite packing required a neuroradiological intervention. An intracranially ruptured pseudoaneurysm was detected by magnetic resonance imaging (MRI) and computed tomography (CT), originating from the internal carotid artery at the junction of the petrous part to the cavernous part. Coiling and endovascular plug embolization was performed for the treatment of aneurysm. Ten months later, the patient removed a foreign body out of his left nose. It was dislocated coil material due to radionecrosis. MRI confirmed sufficient embolization of the internal carotid artery. Conclusions. This case report highlights the possibility of a nasopharyngeal coil dislocation of an embolized internal carotid artery aneurysm emerging as a nasal foreign body.

2015 ◽  
Vol 49 (1) ◽  
pp. 49-51
Author(s):  
Vidya Rattan ◽  
Dinesh Kumar ◽  
Gyana Ranjan Sahu ◽  
KK Mukherjee

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.


2014 ◽  
Vol 48 (2) ◽  
pp. 100-102
Author(s):  
Vidya Rattan ◽  
Dinesh Kumar ◽  
Gyana Ranjan Sahu ◽  
KK Mukherjee

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 hemorrhagic 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 2014;48(2):100-102.


Author(s):  
Santosh Kumar Swain

<p>Epistaxis is commonly encountered by clinicians in emergency department. However, severe and recurrent epistaxis is very uncommon especially that arise from the cavernous internal carotid artery (ICA) pseudoaneurysm. Traumatic cavernous internal carotid pseudoaneurysm is a rare cause of the epistaxis but is a fatal and life-threatening clinical condition if left untreated. Massive epistaxis following head injury should alert the clinician to rule out traumatic cavernous ICA pseudoaneurysm. Traumatic pseudoaneurysm of the cavernous part of the ICA is a challenging clinical entity both in diagnosis and treatment. This clinical diagnosis may be suspected in case of patient with history of head injury, massive recurrent epistaxis and delayed onset of blindness. Massive epistaxis after head trauma should alert the clinician for possible cavernous ICA pseudoaneurysm. Carotid angiography confirms the site of pseudoaneurysm. The treatment options are endovascular stent and coil embolization, arterial balloon occlusion and surgical trapping. Timely diagnosis and treatment of this condition give a favorable outcome. In this review article, we discuss the epidemiology, etiopathology, clinical presentations, investigations and current treatment of the traumatic cavernous ICA pseudoaneurysm.</p>


VASA ◽  
2011 ◽  
Vol 40 (6) ◽  
pp. 491-494 ◽  
Author(s):  
Vávrová ◽  
Slezácek ◽  
Vávra ◽  
Karlová ◽  
Procházka

Internal carotid artery pseudoaneurysm is a rare complication of deep neck infections. The authors report the case of a 17-year-old male who presented to the Department of Otorhinolaryngology with an acute tonsillitis requiring tonsillectomy. Four weeks after the surgery the patient was readmitted because of progressive swallowing, trismus, and worsening headache. Computed tomography revealed a pseudoaneurysm of the left internal carotid artery in the extracranial segment. A bare Wallstent was implanted primarily and a complete occlusion of the pseudoaneurysm was achieved. The endovascular approach is a quick and safe method for the treatment of a pseudoaneurysm of the internal carotid artery.


1978 ◽  
Vol 71 (4) ◽  
pp. 355-362 ◽  
Author(s):  
Makoto Sakatsume ◽  
Akira Kikuta ◽  
Isao Yoshida ◽  
Yoshitsugu Ogawa ◽  
Shigeo Ise

2017 ◽  
Vol 20 (3) ◽  
pp. 239-246
Author(s):  
Sunil Manjila ◽  
Gagandeep Singh ◽  
Obinna Ndubuizu ◽  
Zoe Jones ◽  
Daniel P. Hsu ◽  
...  

The authors demonstrate the use of an endovascular plug in securing a carotid artery pseudoaneurysm in an emergent setting requiring craniotomy for a concurrent subdural empyema.They describe the case of a 14-year-old boy with sinusitis and bifrontal subdural empyema who underwent transsphenoidal exploration at an outside hospital. An injury to the right cavernous segment of the ICA caused torrential epistaxis. Bleeding was successfully controlled by inflating a Foley balloon catheter within the sphenoid sinus, and the patient was transferred to the authors’ institution. Emergent angiography showed a dissection of the right cavernous carotid artery, with a large pseudoaneurysm projecting into the sphenoid sinus at the site of arterial injury. The right internal carotid artery was obliterated using pushable coils distally and an endovascular plug proximally. The endovascular plug enabled the authors to successfully exclude the pseudoaneurysm from the circulation. The patient subsequently underwent an emergent bifrontal craniotomy for evacuation of a left frontotemporal subdural empyema and exenteration of both frontal sinuses. He made a complete neurological recovery.Endovascular large-vessel sacrifice, obviating the need for numerous coils and antiplatelet therapy, has a role in the setting of selected acute neurosurgical emergencies necessitating craniotomy. The endovascular plug is a useful adjunct in such circumstances as the device can be deployed rapidly, safely, and effectively.


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