ISSN: 1300 - 6525 E-ISSN: 2149 - 0880
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CASE REPORTS

A Rare Cause of Recurrent Massive Epistaxis: Post-traumatic Cavernous Carotid Artery Pseudoaneurysm
Rekürren Massif Burun Kanamasının Nadir Bir Nedeni: Travma İlişkili Kavernöz Karotis Psödoanevrizması
Received Date : 04 Jul 2020
Accepted Date : 07 Oct 2020
Available Online : 11 Feb 2020
Doi: 10.24179/kbbbbc.2020-77880 - Makale Dili: EN
KBB ve BBC Dergisi. 2021;29(1):69-73
Copyright © 2020 by Turkey Association of Society of Ear Nose Throat and Head Neck Surgery. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)
ABSTRACT
Internal carotid artery pseudoaneurysm due to head trauma is an extremely rare but life-threatening condition. A pseudoaneurysm in the cavernous segment of the internal carotid artery should be considered in patients with ocular region injury, unilateral vision loss and delayed epistaxis. In cases of cavernous carotid pseudoaneurysm, a period between trauma and the first episode of epistaxis is usually observed. In this paper, a 36-year-old patient with cavernous carotid pseudoaneurysm related to head trauma is presented. The patient's epistaxis started approximately 5 months after the trauma. On his examination, a pulsatile mass in the left nasal cavity was detected, and a diagnosis of giant cavernous carotid pseudoaneurysm was made with computed tomography-angiography imaging. Then, he was successfully treated with coil embolization in the interventional radiology unit.
ÖZET
Kafa travmasına bağlı internal karotid arter psödoanevrizması, oldukça nadir görülen ve yaşamı tehdit eden bir durumdur. Özellikle oküler bölgede kemik kırığı, tek taraflı görme kaybı, gecikmiş burun kanaması bulguları saptanan bir hastada, internal karotid arterin kavernöz segmentinde psödoanevrizma olabileceği akla gelmelidir. Kavernöz karotis psödoanevrizması olgularında, genellikle travma ile ilk burun kanaması atağı arasında bir periyot gözlenir. Bu çalışmada, 36 yaşında kafa travması ile ilişkili kavernöz karotis psödoanevrizması olan bir olgu sunulmuştur. Olgunun, travmadan yaklaşık 5 ay sonra masif ve tekrarlayıcı karakterde burun kanaması başlamıştı. Muayenesinde sol nazal kavitede pulsatil kitle saptanan hastaya uygulanan bilgisayarlı tomografi-anjiyografi görüntüleri ile dev kavernöz karotis psödoanevrizması tanısı kondu. Ardından girişimsel radyoloji ünitesinde koil embolizasyon ile başarılı bir şekilde tedavi edildi.
KAYNAKLAR
  1. Chen G, Li J, Xu G, Qin S, Gong J, Yang M, et al. Diagnosis and treatment of traumatic internal carotid artery pseudoaneurysm primarily manifested by repeated epistaxis. Turk Neurosurg. 2013;23(6):716-20.[Crossref] [PubMed] 
  2. Sridharan R, Low SF, Mohd MR, Kew TY. Intracavernous internal carotid artery pseudoaneurysm. Singapore Med J. 2014;55(10):e165-8.[Crossref] [PubMed] [PMC] 
  3. Bhatoe HS, Suryanarayana KV, Gill HS. Recurrent massive epistaxis due to traumatic intracavernous internal carotid artery aneurysm. J Laryngol Otol. 1995 Jul;109(7):650-2.[Crossref] [PubMed] 
  4. Asma A, Putra SH, Saim L. Massive epistaxis secondary to pseudoaneurysm of internal carotid artery. Med J Malaysia. 2006;61(1):84-7.[PubMed] 
  5. Chen D, Concus AP, Halbach VV, Cheung SW. Epistaxis originating from traumatic pseudoaneurysm of the internal carotid artery: diagnosis and endovascular therapy. Laryngoscope. 1998;108(3):326-31.[Crossref] [PubMed] 
  6. Stiebel-Kalish H, Kalish Y, Bar-On RH, Setton A, Niimi Y, Berenstein A, et al. Presentation, natural history, and management of carotid cavernous aneurysms. Neurosurgery. 2005;57(5):850-7.[Crossref] [PubMed] 
  7. Zipfel GJ, Dacey RG. Update on the management of unruptured intracranial aneurysms. Neurosurg Focus. 2004;17(5):E2.[Crossref] [PubMed] 
  8. Ruiz-Juretschke F, Castro E, Mateo Sierra O, Iza B, Manuel Garbizu J, Fortea F, et al. Massive epistaxis resulting from an intracavernous internal carotid artery traumatic pseudoaneurysm: complete resolution with overlapping uncovered stents. Acta Neurochir (Wien). 2009;151(12):1681-4.[Crossref] [PubMed] 
  9. Han MH, Sung MW, Chang KH, Min YG, Han DH, Han MC. Traumatic pseudoaneurysm of the intracavernous ICA presenting with massive epistaxis: imaging diagnosis and endovascular treatment. Laryngoscope. 1994;104(3 Pt 1):370-7.[Crossref] [PubMed] 
  10. Chambers EF, Rosenbaum AE, Norman D, Newton TH. Traumatic aneurysms of cavernous internal carotid artery with secondary epistaxis. AJNR Am J Neuroradiol. 1981;2(5):405-9.[PubMed] 
  11. Higashida RT, Halbach VV, Dowd C, Barnwell SL, Dormandy B, Bell J, et al. Endovascular detachable balloon embolization therapy of cavernous carotid artery aneurysms: results in 87 cases. J Neurosurg. 1990;72(6):857-63.[Crossref] [PubMed] 
  12. Choulakian A, Drazin D, Alexander MJ. Endosaccular treatment of 113 cavernous carotid artery aneurysms. J Neurointerv Surg. 2010;2(4):359-62.[Crossref] [PubMed] 
  13. Lempert TE, Halbach VV, Higashida RT, Dowd CF, Urwin RW, Balousek PA, et al. Endovascular treatment of pseudoaneurysms with electrolytically detachable coils. AJNR Am J Neuroradiol. 1998;19(5):907-11.[PubMed]