J Korean Neurosurg Soc.  1988 Apr;17(2):367-374.

Massive Epistaxis from Carotid Artery Injuries Associated with Blunt Head Trauma: Report of 2 Cases

• Kim SW
• Shin WH
• Choi SK
• Byun BJ
• Lee IS

Abstract

Two cases of massive epistaxis following nonpenetrating head injury are reported. A 23-year-old man was referred to us because of massive epistaxis and binocular blindness which developed about two months after a head injury. Carotid angiography demonstrated a intracavernous carotid aneurysm protruding into the ethmoid and sphenoid sinuses, and occlusion of the supraclinoid part of contralateral carotid artery. CT scan demonstrated a large hyperdense mass extending into the parasellar area, the ethmoid and sphenoid sinuses, and both orbits with destruction of bony structures. Treatment was delayed because the patient developed typhoid fever and sepsis, he died about six months after a head injury from a severe cerebral infarction due to internal carotid artery occlusion. A 34-year-old man, involved in a car accident, was admitted in semicomatose state. Over the next 72 hr he become more alert but he had massive epistaxis 11 day later which required blood transfusions. Carotid angiography revealed a false aneurysm of the distal part of the internal maxillary artery. About 30 days later, the false aneurysm occluded by embolization with Gelfoam. The patient recovered uneventfully from these procedures.

Keyword

Blunt head injury; Epistaxis; Traumatic aneurysm; Internal carotid artery; External carotid artery; Embolization

MeSH Terms

Adult
Aneurysm
Aneurysm, False
Angiography
Blindness
Blood Transfusion
Carotid Arteries*
Carotid Artery Injuries*
Carotid Artery, External
Carotid Artery, Internal
Cerebral Infarction
Craniocerebral Trauma*
Epistaxis*
Gelatin Sponge, Absorbable
Head Injuries, Closed
Head*
Humans
Maxillary Artery
Orbit
Sepsis
Sphenoid Sinus
Telescopes
Tomography, X-Ray Computed
Typhoid Fever
Young Adult