Aim and objective: To diagnose and treat a rare instance of intractable large recurring epistaxis.
Background: Traumatic intracranial pseudoaneurysm is a rare complication of blunt trauma. A ruptured intracranial internal carotid artery pseudoaneurysm can cause significant, recurrent epistaxis that requires rapid medical care.
We present a case of recurrent massive intractable epistaxis caused by sphenoidal prolapse of the supraclinoid part of the right internal carotid artery, presenting as a pseudoaneurysm, secondary to a post-traumatic fracture dehiscence of the roof of the sphenoid, as diagnosed by computed tomography angiography. To successfully treat the patient, a main endovascular coiling was performed.
Conclusion: Although intractable epistaxis induced by a post-traumatic pseudoaneurysm is uncommon, it can be fatal. As a result, it should be evaluated in the differential diagnosis of massive recurrent unmanageable epistaxis and treated promptly.
Clinical Importance: Because such uncommon instances are difficult to diagnose and treat, the spectrum of possible presentations should be broadened. Patients’ lives may be lost as a result of inadequate and late diagnosis and treatment in such circumstances.
Department of ENT, Kempegowda Institute of Medical Sciences, Bengaluru, Karnataka, India.
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