Epistaxis due to Traumatic Intracavernous Aneurysm

Lee, Jen-pei; Wang, Alexander Dah-jium

doi:10.1097/00005373-199005000-00017

Cited by 17 publications

(11 citation statements)

References 0 publications

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“…A traumatic cavernous internal carotid artery aneurysm (CICAA) is an even rarer complication of head injury, comprising less than 1-2% of all intracranial aneurysms (Handa and Handa, 1976). Since the first confirmed case by Cairns (1942), no more than 100 cases have been described in the literature (Lee and Wang, 1990). The hallmark of presentation of a CICAA is delayed epistaxis from 7 days to 39 years after head trauma with a mortality from epistaxis as high as 30 -50% (Chambers et al, 1981).…”

Section: Discussionmentioning

confidence: 99%

“…This stage did not show yet on the CT scan. The initial trauma may give rise to a true (rupture through all layers of the vessel) or false aneurysm of the internal carotid artery depending on the degree of injury to the wall of the artery (Lee and Wang, 1990). The relatively fixed nature of the internal carotid artery at its entrance into, and exit from, the cavernous sinus may make it susceptible to injury here.…”

Section: Discussionmentioning

confidence: 99%

“…Giant intracranial carotid artery aneurysms (GICAA) may present either as a space-occupying lesion with focal neurological signs (Jefferson, 1938), a carotid cavernous fistula, or as a delayed, recurrent, and massive epistaxis (Lee and Wang, 1990) with ocular manifestations (Maurer et al, 1961). They may expand and result in significant erosion of the bone of the base of the skull, and even extend extracranially (Fisher et al, 1994).…”

Section: Introductionmentioning

confidence: 99%

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Giant intracavernous internal carotid artery aneurysm with fatal epistaxis

Haffajee

Naidoo

2003

Clinical Anatomy

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The case history and autopsy findings of a 32-year-old male, who suffered a mild closed-head injury and then had repeated epistaxis beginning 5 months later, is presented. The condition culminated in an episode of fatal epistaxis 1 year after the injury. At one time during the course of his work-up, the etiology of his repeated epistaxis was thought to be a vascular nasopharyngeal neoplasm. The diagnosis of an intracavernous internal carotid artery aneurysm was made only at autopsy. The principles of management of traumatic intracavernous internal carotid artery aneurysm presenting with epistaxis are discussed.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Giant intracavernous internal carotid artery aneurysm with fatal epistaxis

Haffajee

Naidoo

2003

Clinical Anatomy

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“…These aneurysms might enlarge and produce a cavernous sinus syndrome with nerve compression, or they might secondarily rupture producing a CCF, and transdural leakage will lead to a subarachnoid hemorrhage. The most dangerous form, however, is a medial tear of the ICA with rupture into the sphenoid sinus causing massive and life-threatening epistaxis [26,29] (Fig. 7).…”

Section: Traumatic Aneurysmsmentioning

confidence: 99%

Cerebrovascular trauma

2008

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Vascular injury of the head and neck region is a rare and often life-threatening complication of head or neck trauma and is due to two major pathomechanisms: penetrating or blunt trauma. Both the arterial and the venous site of the CNS vasculature can be involved, the latter one being often overlooked. Concerning arterial lesions, depending on how many layers of the arterial vessel are affected and on the spatial relationship to adjacent structures, dissections, false aneurysms or arteriovenous fistulae may develop. On the venous side, dural tears, compressive effects on pial veins and a deranged clotting system may lead to delayed venous thrombosis. In this review we describe clinical and imaging findings, as well as diagnostic and treatment strategies in these lesions.

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“…A triad of history of head injury, monocular blindness and epistaxis is usually found in these patients (Maurer et al, 1961). Although more than 100 cases of traumatic intracavernous ICA aneurysms have been reported in the world literature (Chambers et al, 1981;Simpson et al, 1988;Lee and Wang, 1990), the best management of this lesion remains unclear. We present a case of traumatic intracavernous ICA aneurysms managed by common carotid ligation.…”

Section: Introductionmentioning

confidence: 99%