Cavernous carotid aneurysm presenting with epistaxis

Abstract

Background: Carotid artery aneurysms are a rare cause of epistaxis. The most common presentation for nontraumatic cavernous internal carotid artery aneurysms is mass effect, with only 3% presenting with hemorrhage. We present a case of epistaxis caused by a nontraumatic cavernous internal carotid artery aneurysm.

Methods: A 73-year-old white woman was seen with a 1-month history of recurrent right-sided epistaxis. The patient had essential hypertension and a family history of intracranial aneurysm. A complete otolaryngologic, neurologic, and ophthalmologic examinations were normal. Contrast-enhanced CT of the paranasal sinuses revealed a trilobed aneurysm of the cavernous segment of the right internal carotid artery. Coil embolization of the cavernous aneurysm and right internal artery was performed.

Results: The patient has had no further episodes of epistaxis and has remained neurologically intact.

Conclusion: Carotid artery aneurysms must be considered in the differential diagnosis of profuse epistaxis.