Ruptured Intracranial Carotid Artery Aneurysm with Fatal Epistaxis

Seftel, Daniel M.; Kolson, Harry; Gordon, Benjamin S.

doi:10.1001/archotol.1959.00730040056009

Cited by 46 publications

(18 citation statements)

References 7 publications

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“…14) The lateral bony wall of the sphenoid sinus is often less than 2 mm thick, so an aneurysm can easily erode through the bone and appear in the sphenoid sinus. 16) Erosion of the sphenoid sinus was observed in our patient, and severe epistaxis developed about 2 years after the diagnosis. However, the bone condition of the sphenoid sinus did not change over 22 months of follow up.…”

Section: Discussionmentioning

confidence: 51%

Massive Epistaxis From a Thrombosed Intracavernous Internal Carotid Artery Aneurysm 2 Years After the Initial Diagnosis -Case Report-

Nomura

Shima

Sugihara

et al. 2010

Neurol. Med. Chir.(Tokyo)

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A 77-year-old woman presented with a rare case of nontraumatic intracavernous internal carotid artery (ICA) aneurysm causing epistaxis. The thrombosed aneurysm was discovered incidentally, and was not treated. However, she suffered massive nasal bleeding 22 months after the initial diagnosis. The lesion was successfully treated by endovascular coil embolization. The present case shows that thrombosed intracavernous ICA aneurysm may still carry the risk of rupture. Radiological evidence of erosion of the sphenoid sinus wall and repeated minor bleeding may be important predicting signs for massive nasal bleeding. Parent artery occlusion including the aneurysm may be the best treatment for intracavernous ICA aneurysms if sufficient collateral blood flow to the territory of the affected ICA is expected.

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Section: Discussionmentioning

confidence: 51%

Massive Epistaxis From a Thrombosed Intracavernous Internal Carotid Artery Aneurysm 2 Years After the Initial Diagnosis -Case Report-

Nomura

Shima

Sugihara

et al. 2010

Neurol. Med. Chir.(Tokyo)

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“…In contrast, traumatic aneurysms are the result of torsion of the vessel and tearing of the elastic, muscular, and even adventitial layers of the vessel wal1. 5 Both types of aneurysms, when arising from the intracranial internal carotid artery, can present with a constellation of head and neck symptoms and may even anatomically intrude into the otolaryngologist's domain as they grow.…”

Section: Discussionmentioning

confidence: 99%

“…For aneurysms of any internal carotid location, headache or pain projected to the orbit, inner canthus, forehead, or nose is common. 5 The astute clinician, considering a diagnosis of intracranial aneurysm, should carefully check for problems with headaches, eye movement, vision, or facial sensory changes. In fact Jaeger, in an analysis of 31 cases of intracranial carotid aneurysms, found that the combined symptoms of oculomotor paresis associated with frontal or orbital head pains are sufficient to permit a presumptive diagnosis of aneurysm.…”

Section: Discussionmentioning

confidence: 99%

Nontraumatic Carotid-Ophthalmic Aneurysm Presenting as Recurrent Epistaxis

Kotton

Itani

1995

American Journal of Rhinology

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Recurrent epistaxis can be a rare presentation of ruptured internal carotid artery aneurysm. Although primarily a neurosurgical problem, these cases may be seen initially by the otolaryngologist, as the aneurysm erodes through the thin adjacent sphenoid sinus wall and ruptures, producing epistaxis. In most cases these aneurysms are traumatic in origin. We present the first cited case of a nontraumatic internal carotid aneurysm, arising from the origin of the ophthalmic artery, which presented as intermittent epistaxis from the sphenoid sinus. We suggest that aneurysmal rupture be considered in the differential diagnosis of all cases of epistaxis from the sphenoid sinus. Nasal endoscopy and CT scan of the paranasal sinuses in nonemergent cases is valuable in localizing the source of the bleed. Furthermore, preoperative angiography is essential in making the diagnosis of aneurysm and avoiding fatal torrential hemorrhage caused by nasal surgery. Once the diagnosis is made, the definitive treatment is surgical or intravascular trapping of the aneurysm. (American Journal of Rhinology 9:9-13, 1995)

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“…Seftel et al [57] found projections of this kind in 65%, and noted that they were conspicuous in 53% of these. Renn and Rhoton [55] demonstrated carotid prominences in 71%.…”

Section: Lateral Wallmentioning

confidence: 96%

Hypophyseal region — anatomy of the operative approaches

Lang

1985

Neurosurg. Rev.

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Landmarks and measurements for the transnasal approach (apertura piriformis, distance to the apertura sinus sphenoidalis) in children and adults are given. Included is the anatomy of the nasal septum, its vessels and nerves. The ostium of the sphenoid sinus, its development, types and dimensions are described. Also shown are the hypophyseal capsule, the hypophyseal vessels and the hypophyseal fossa with its variations and the sella turcica region with its adjacent dural structures (petroclinoid fold, diaphragma sellae, aperture for the internal carotid artery and pituitary cistern). For the intracranial approaches the arterial circle and its branches are important for neurosurgeons. The location, number, width and course of these branches are described. Distances and the most important vessels, which are seen by frontal, frontolateral and pterional approaches, are described.

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Ruptured Intracranial Carotid Artery Aneurysm with Fatal Epistaxis

Cited by 46 publications

References 7 publications

Massive Epistaxis From a Thrombosed Intracavernous Internal Carotid Artery Aneurysm 2 Years After the Initial Diagnosis -Case Report-

Massive Epistaxis From a Thrombosed Intracavernous Internal Carotid Artery Aneurysm 2 Years After the Initial Diagnosis -Case Report-

Nontraumatic Carotid-Ophthalmic Aneurysm Presenting as Recurrent Epistaxis

Hypophyseal region — anatomy of the operative approaches

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