Recurrent massive epistaxis due to traumatic intracavernous internal carotid artery aneurysm

Bhatoe, Harjinder S; Suryanarayana, K. V.; Gill, Heather L.

doi:10.1017/s0022215100130932

Cited by 30 publications

(22 citation statements)

References 19 publications

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“…4). 8,29,34,35,56 Furthermore, CCAs that show evidence of growth, regardless of size, should be considered for treatment, because growth has been reported to increase the risk of rupture. 32,52 Acute thrombotic and ruptured CCAs are considered unstable lesions and are usually treated expediently, as the symptoms that patients present with are acute and progressive.…”

Section: To Treat or Not To Treat-that Is The Questionmentioning

confidence: 99%

Cavernous carotid aneurysms: to treat or not to treat?

Eddleman¹,

Hurley

Bendok

et al. 2009

FOC

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Most cavernous carotid aneurysms (CCAs) are considered benign lesions, most often asymptomatic, and to have a natural history with a low risk of life-threatening complications. However, several conditions may exist in which treatment of these aneurysms should be considered. Several options are currently available regarding the management of CCAs with resultant good outcomes, namely expectant management, luminal preservation strategies with or without addressing the aneurysm directly, and Hunterian strategies with or without revascularization procedures. In this article, we discuss the sometimes difficult decision regarding whether to treat CCAs. We consider the natural history of several types of CCAs, the clinical presentation, the current modalities of CCA management and their outcomes to aid in the management of this heterogeneous group of cerebral aneurysms.

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Section: To Treat or Not To Treat-that Is The Questionmentioning

confidence: 99%

Cavernous carotid aneurysms: to treat or not to treat?

Eddleman¹,

Hurley

Bendok

et al. 2009

FOC

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“…The thin interface of tissue between these structures makes this a site for potential injury in trauma and surgery of the sphenoid sinus (7,12). ICA PA can rarely present as recurrent epistaxis, though most of them result in massive bleeding due to rupture into the sphenoid sinus (4,5,7). Intracavernous ICA PA are in close anatomic proximity to other cavernous structures and thus may be associated with injury to cranial nerves II, III, IV, V1-2, and VI, as well as the ophthalmic artery.…”

Section: █ Resultsmentioning

confidence: 99%

Internal carotid artery aneurysms presenting with epistaxis - our experience and review of literature

Garg

Hk²,

Pk³

et al. 2014

Turkish Neurosurgery

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Intraarterial digital subtraction angiography is the diagnostic modality of choice. The management of such cases is challenging due to the relative anatomical inaccessibility of the bleeding point. Management depends on the status of cross circulation. If the cross circulation is adequate, carotid sacrifice (either endovascular or surgical) is a treatment option and if it is inadequate, one is left with the options of either extracranial intracranial bypass or selective embolization of the pseudoaneurysm. We studied 4 such cases, managed surgically at our center.

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“…These pseudoaneurysms may either be asymptomatic or tear into the sphenoid sinus and present with delayed torrential epistaxis. (6) Recurrent epistaxis occurs, as a small, full thickness tear of the ICA can temporarily seal off from a haematoma within the enclosure of the sphenoid sinus. (7) The cavernous ICA has been observed to protrude into the lateral wall of the sphenoid sinus in 70% of cadaveric specimens, as it is intimately related to this sinus.…”

Section: Discussionmentioning

confidence: 99%