Arterial Embolization in the Treatment of Severe Epistaxis: A Case Report

Abstract

Nasal hemorrhage or epistaxis is a common finding in the emergency department. The causes of epistaxis are varied and can be classified as local, systemic or a combination of both. The aim of this study was to report a case of embolization of branches of the maxillary artery for treatment of epistaxis secondary to facial trauma. A 43-year-old man suffered blunt trauma in the frontonasal area as a result of a bicycle accident. It presented with amnesia, severe epistaxis, panfacial edema and nasal deformity. The patient was hypotensive and hypothermic, with evidence of hemorrhagic intracranial. Orotracheal intubation was performed immediately to protect the airways and prevent aspiration of blood to the lower respiratory tract. The occlusion of the artery was successful and was immediately followed by cessation of oronasal bleeding. The patient was discharged after ten days. Arterial embolization should be the gold-standard treatment, which provides a safe and effective alternative for the control of epistaxis.

Severe Traumatic Brain Injury with Sphenopalatine Artery Ruptured: Case Report and Review of the Literature

“…Oronasal hemorrhage from venous origin or minor arterial vessels due to severe TBI followed by maxillofacial trauma can often be managed efficiently with packing. However, if bleeding persists and threatened the patient's life, vessel ligation and arterial embolization are treatment options [6] [8] [9]. Cerebral angiography can help to identify the site of the bleeding, abnormal circulation, aneurysms, and arteriovenous malformations.…”