scholarly journals Traumatic cavernous internal carotid artery pseudoaneurysm presenting with massive epistaxis-a morbid clinical entity

2020 ◽  
Vol 6 (12) ◽  
pp. 2323
Author(s):  
Santosh Kumar Swain
Keyword(s):  
Head Injury ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Treatment Options ◽  
Balloon Occlusion ◽  
Clinical Entity ◽  
Diagnosis And Treatment ◽  
Artery Pseudoaneurysm ◽  
Recurrent Epistaxis

<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>

scholarly journals Cervical to Petrous Carotid Artery High-Flow Bypass for Carotid Artery Pseudoaneurysm Through Zygomatic Approach: 2-Dimensional Operative Video

2021 ◽  
Author(s):  
Rami O Almefty ◽  
Ossama Al-Mefty
Keyword(s):  
Carotid Artery ◽  
Internal Carotid ◽  
Treatment Options ◽  
Penetrating Trauma ◽  
Mass Effect ◽  
Carotid Bifurcation ◽  
Carotid Stenting ◽  
Balloon Occlusion ◽  
High Flow ◽  
Artery Pseudoaneurysm

Abstract Pseudoaneurysms of the cervical internal carotid artery may generate grave risk from catastrophic rupture, thromboembolic stroke, or mass effect. They have many causes, including malignancy, infection, and iatrogenic and most commonly blunt or penetrating trauma.1 These aneurysms require treatment to eliminate their risk. Treatment options include trapping, with or without revascularization, or endovascular stenting. Trapping without revascularization requires evaluation of the cerebral collateral under a physiological challenge, which is usually done with a balloon occlusion test, which is not applicable in this lesion.2 Occluding the carotid without revascularization carries the risk of delayed ischemia and aneurysm formation.3,4 Carotid stenting has been applied in the treatment of these lesions5,6; however, the extent of the lesion in our patient from the carotid bifurcation to the petrous carotid makes endovascular treatment challenging. We present a patient with a delayed post-traumatic pseudoaneurysm of the carotid artery that extended from the bifurcation to the petrous carotid who was treated with trapping and high-flow saphenous vein bypass from the proximal cervical internal carotid to the petrous carotid. Adequate exposure of the petrous carotid to perform anastomosis requires a thorough knowledge of the anatomy and surgical nuances, which we demonstrate here through a zygomatic approach.7 The patient consented to the procedure and publication of imaging. Image at 2:28 from Al-Mefty O, Operative Atlas of Meningiomas, © LWW, 1997, with permission.

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.

Emergency balloon occlusion for massive epistaxis due to traumatic carotid-cavernous aneurysm

1988 ◽  
Vol 68 (1) ◽  
pp. 142-144 ◽  
Author(s):  
Richard K. Simpson ◽  
Richard L. Harper ◽  
R. Nick Bryan
Keyword(s):  
Head Injury ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Balloon Occlusion ◽  
Traumatic Aneurysm ◽  
Acute Hemorrhage ◽  
Content Type ◽  
The Right ◽  
Fine Print

✓ A patient with a giant traumatic aneurysm of the right internal carotid artery presented with recurrent massive epistaxis 30 years after a head injury. During an episode of acute hemorrhage, this patient was effectively treated with occlusion of the internal carotid artery circulation by a detachable inflatable balloon.

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

2014 ◽  
Vol 48 (2) ◽  
pp. 100-102
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 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.

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
Keyword(s):  
Foreign Body ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Rare Event ◽  
Recurrent Bleeding ◽  
Safe Procedure ◽  
Artery Pseudoaneurysm ◽  
Recurrent Epistaxis ◽  
Severe Epistaxis

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.

Pseudoaneurysm of the left internal carotid artery following tonsillectomy

VASA ◽  
2011 ◽  
Vol 40 (6) ◽  
pp. 491-494 ◽  
Author(s):  
Vávrová ◽  
Slezácek ◽  
Vávra ◽  
Karlová ◽  
Procházka
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Rare Complication ◽  
Left Internal Carotid Artery ◽  
Acute Tonsillitis ◽  
Artery Pseudoaneurysm ◽  
Complete Occlusion ◽  
Endovascular Approach ◽  
Deep Neck Infections

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.

scholarly journals Internal Carotid Artery Injury in Transsphenoidal Surgery: Tenets for Its Avoidance and Refit—A Clinical Study

2021 ◽  
Vol 11 (1) ◽  
pp. 99
Author(s):  
Dmitry Usachev ◽  
Oleg Sharipov ◽  
Ashraf Abdali ◽  
Sergei Yakovlev ◽  
Vasiliy Lukshin ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Cavernous Sinus ◽  
Transsphenoidal Surgery ◽  
Internal Carotid ◽  
Treatment Options ◽  
Carotid Artery Injury ◽  
Anatomical Features ◽  
Stent Grafting ◽  
Internal Carotid Artery Injury

One of the most serious/potentially fatal complications of transsphenoidal surgery (TSS) is internal carotid artery (ICA) injury. Of 6230 patients who underwent TSS, ICA injury occurred in 8 (0.12%). The etiology, possible treatment options, and avoidance of ICA injury were analyzed. ICA injury occurred at two different stages: (1) during the exposure of the sella floor and dural incision over the sella and cavernous sinus and (2) during the resection of the cavernous sinus extension of the tumor. The angiographic collateral blood supply was categorized as good, sufficient, and nonsufficient to help with the decision making for repairing the injury. ICA occlusion with a balloon was performed at the injury site in two cases, microcoils in two patients, microcoils plus a single barrel extra-intracranial high-flow bypass in one case, stent grafting in one case, and no intervention in two cases. The risk of ICA injury diminishes with better preoperative preparation, intraoperative navigation, and ultrasound dopplerography. Reconstructive surgery for closing the defect and restoring the blood flow to the artery should be assessed depending on the site of the injury and the anatomical features of the ICA.

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