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Case Reports
. 2014 Oct;55(10):e165-8.
doi: 10.11622/smedj.2014148.

Intracavernous internal carotid artery pseudoaneurysm

Radhika Sridharan  1 , Soo Fin Low, Mohd Redzuan Mohd, Thean Yean Kew
Affiliations
Case Reports

Intracavernous internal carotid artery pseudoaneurysm

Radhika Sridharan et al. Singapore Med J. 2014 Oct.

Abstract

Epistaxis is commonly encountered in otorhinolaryngologic practice. However, severe and recurrent epistaxis is rarely seen, especially that originating from a pseudoaneurysm of the intracavernous internal carotid artery (ICA). We herein present the case of a 32-year-old man who was involved in a motor vehicle accident and subsequently developed recurrent episodes of profuse epistaxis for the next three months, which required blood transfusion and nasal packing to control the bleeding. Computed tomography angiography revealed a large intracavernous ICA pseudoaneurysm measuring 1.7 cm × 1.2 cm × 1.0 cm. The patient underwent emergent four-vessel angiography and coil embolisation and was discharged one week later without any episode of bleeding. He remained asymptomatic after three-month and one‑year intervals. This case report highlights a large intracavernous ICA pseudoaneurysm as a rare cause of epistaxis, which requires a high index of suspicion in the right clinical setting and emergent endovascular treatment to prevent mortality.

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Figures

Fig. 1
Fig. 1
CT angiogram shows a linear fracture of the lateral wall of the left sphenoid sinus (arrow).
Fig. 2
Fig. 2
CT angiogram shows a well-demarcated, avidly enhancing lesion in the left sphenoid sinus (arrow), suggestive of a pseudoaneurysm of the intracavernous portion of the left ICA.
Fig. 3
Fig. 3
Catheter angiograms show the (a) anterior-posterior and (b) lateral views of the left ICA, confirming the presence of the pseudoaneurysm.
Fig. 4
Fig. 4
Post-coil embolisation angiogram of the left ICA shows successful occlusion of the pseudoaneurysm (arrow).
See this image and copyright information in PMC

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