Traumatic Aneurysm of the Internal Carotid Artery

Shirai, Shizuo; Tomono, Yuji; Owada, Tetsuo; Maki, Yutaka

doi:10.1159/000114835

Cited by 21 publications

(2 citation statements)

References 3 publications

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“…Traumatic injury of the cavernous carotid artery usually manifests as cavernous-carotid fistula. Traumatic pseudoaneurysm of this region may also occur although it is a rare condition 2 . As Maurer et Al 1 already described, the pseudoaneurysm should be considered when there are visual disturbances and sudden onset of ipsilateral posterior epistaxis in a patient with a history of head trauma.…”

Section: Discussionmentioning

confidence: 99%

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A Recurred Carotid Siphon Pseudoaneurysm after Detachable Coil Embolization

Sj³

et al. 2002

Interv Neuroradiol

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Massive posterior epistaxis is one of the peculiar symptoms of pseudoaneurysms of the carotid siphon. We experienced a case of trauma-related pseudoaneurysm of the carotid siphon. The lesion was initially silent except for the mass effect. We initially treated the lesion with platinum detachable coil embolization of the pseudoaneurysm sac with preservation of the parent artery. However, the patient had delayed massive epistaxis with recurrence of the pseudoaneurysm. The patient was subsequently managed with endovascular occlusion of the affected internal carotid artery using detachable balloons. Complete internal carotid artery trapping is recommended as an initial treatment modality if the patient can tolerate to the occlusion test. Careful observation and follow-up of the patient is required if the lesion is inevitably managed with coil embolization of the pseudoaneurysm sac alone.

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Section: Discussionmentioning

confidence: 99%

“…ical triad -history of head trauma, ipsilateral visual loss, and massive epistaxis, which was first described by Maurer et Al in 1961 1 . There have been some case reports on the lesion mainly featured by massive posterior epistaxis [2][3][4] .…”

mentioning

confidence: 99%

A Recurred Carotid Siphon Pseudoaneurysm after Detachable Coil Embolization

Sj³

et al. 2002

Interv Neuroradiol

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Intracavernous carotid pseudoaneurysm after blunt trauma: Case report and discussion

Reiber

Burkey

1994

Head & Neck

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Epistaxis following blunt facial trauma is usually self-limited and arises from the nasal mucosa, sphenopalatine, or anterior ethmoid arteries. Pseudoaneurysm of the intracavernous carotid artery (ICCA) occurs rarely with penetrating facial trauma, but is even more rare following blunt trauma. Rupture carries a greater than 50% mortality. Because rupture usually occurs after several episodes of epistaxis, recognition of subtle historic and physical findings is paramount to optimal management. Once suspicion is raised, definitive diagnosis and treatment is best accomplished with cerebral arteriogram and trapping of the pseudoaneurysm. We have noted that rupture may be precipitated by angiography, and therefore, we advocate availability of emergent and definitive treatment equipment and personnel prior to performing cerebral arteriography. This should include an otolaryngologist, an interventional radiologist, and a neurosurgeon. A case of ICCA pseudoaneurysm is presented, and the key historic factors are discussed. Radiographic diagnosis and management options are discussed.

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頭蓋底骨折後遅発性に鼻出血を契機に発見された内頸動脈仮性瘤の1例(A case of delayed discovery of a internal carotid artery pseudoaneurysm by nosebleeds after skull base fracture)

亮丞

智也

元

et al. 2021

Nihon Kyukyu Igakukai Zasshi: Japanese Journal of Japanese Asso

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要旨　頭部外傷に伴う頭蓋底骨折はときに仮性動脈瘤を合併する。今回我々は，頭蓋底骨折後受傷時に損傷を認めなかった右内頸動脈に遅発性に仮性動脈瘤を形成した1例を経験したので報告する。症例は74歳の男性。約3mの高さから墜落し顔面を強打した。救急隊接触時，外表上頭部・顔面に外傷を認め，発語不能であったため，重症頭部外傷が疑われ当院へ搬送された。来院時CT検査において右視神経損傷を伴う頭蓋底骨折，脳挫傷，外傷性くも膜下出血，右肩甲骨骨折，多発肋骨骨折を認めたが，仮性動脈瘤は認めなかった。上記各外傷に対し保存的加療を行い，第19病日軽快転医となった。第38病日初回の鼻出血を認めた。第47病日中等量の鼻出血を認め，鼻腔内ガーゼ充填で止血を得た。第79病日より隔日で鼻出血を認めるようになったが，耳鼻科診察では鼻粘膜に特記すべき異常を認めなかった。第84病日多量の鼻出血と血圧低下，冷汗を認め，造影CTで右内頸動脈に仮性動脈瘤を認めたため，当院へ再度転医となった。第85病日右浅側頭動脈–中大脳動脈吻合術および右内頸動脈瘤コイル塞栓術を行い，第90病日MRAで瘤への血流がないことを確認した。第96病日に転医し，第106病日独歩退院となった。本症例では頭部外傷後の鼻出血により，仮性動脈瘤を発見し得た。頭蓋底骨折後の血管評価は受傷時に損傷を認めなくても継時的な画像評価などを慎重に行う必要がある。

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Traumatic Aneurysm of the Internal Carotid Artery

Abstract: We report a case of late severe epistaxis caused by traumatic aneurysm arising from the cavernous portion of the internal carotid artery as the result of a basal skull fracture. We discuss the clinical characteristics of this condition with a review of the literature.

Cited by 21 publications

References 3 publications

A Recurred Carotid Siphon Pseudoaneurysm after Detachable Coil Embolization

A Recurred Carotid Siphon Pseudoaneurysm after Detachable Coil Embolization

Intracavernous carotid pseudoaneurysm after blunt trauma: Case report and discussion

頭蓋底骨折後遅発性に鼻出血を契機に発見された内頸動脈仮性瘤の1例(A case of delayed discovery of a internal carotid artery pseudoaneurysm by nosebleeds after skull base fracture)

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