J Rhinol.  2024 Mar;31(1):46-51. 10.18787/jr.2023.00072.

Internal Carotid Artery Pseudoaneurysm in a Patient Presenting With Recurrent Epistaxis: A Case Report and Literature Review

• Kim H
• Choi JY

• KMID: 2554091
• DOI: http://doi.org/10.18787/jr.2023.00072

Abstract

Traumatic pseudoaneurysms are uncommon vascular lesions that can result from traumatic injuries to the nasal and facial areas. They pose a significant clinical challenge due to their potential to cause recurrent and life-threatening epistaxis. Understanding the underlying vascular anatomy, causes, and treatment options is essential for optimizing patient outcomes. In this case report, we present a 55-year-old man who developed a traumatic pseudoaneurysm of the sphenoid sinus, arising from the cavernous segment of the internal carotid artery following a traumatic incident. This case was successfully managed with stent-assisted coil embolization.

Keyword

Trauma; Epistaxis; Pseudoaneurysm

Figure

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  Fig. 1. Intraoperative endoscopic images. A: Sphenoid sinus opening. B: A soft tissue mass with pulsation, suspicious for a pseudoaneurysm, was seen inside the sphenoid sinus.

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  Fig. 2. Computed tomography angiography findings revealed a pseudoaneurysm arising from the cavernous segment of the internal carotid artery in proximity to the site of trauma (arrow).

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  Fig. 3. Stent-assisted coil embolization of the sphenopalatine artery pseudoaneurysm (arrow in A and B). A: 3D computed tomography angiography. B: Digital subtraction angiography.

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  Fig. 4. After surgery, the coil (arrow) was located in the posterior wall of the sphenoid sinus.

Reference

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