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Journal of Korean Neurosurgical Society > Volume 17(2); 1988 > Article
Journal of Korean Neurosurgical Society 1988;17(2): 367-374.
Massive Epistaxis from Carotid Artery Injuries Associated with Blunt Head Trauma: Report of 2 Cases.
Sang Won Kim, Won Han Shin, Soon Kwon Choi, Bark Jang Byun, In Soo Lee
Department of Neurosurgery, College of Medicine, Soonchunhyang University, Seoul, Korea.
ABSTRACT
Two cases of massive epistaxis following nonpenetrating head injury are reported. A 23-year-old man was referred to us because of massive epistaxis and binocular blindness which developed about two months after a head injury. Carotid angiography demonstrated a intracavernous carotid aneurysm protruding into the ethmoid and sphenoid sinuses, and occlusion of the supraclinoid part of contralateral carotid artery. CT scan demonstrated a large hyperdense mass extending into the parasellar area, the ethmoid and sphenoid sinuses, and both orbits with destruction of bony structures. Treatment was delayed because the patient developed typhoid fever and sepsis, he died about six months after a head injury from a severe cerebral infarction due to internal carotid artery occlusion. A 34-year-old man, involved in a car accident, was admitted in semicomatose state. Over the next 72 hr he become more alert but he had massive epistaxis 11 day later which required blood transfusions. Carotid angiography revealed a false aneurysm of the distal part of the internal maxillary artery. About 30 days later, the false aneurysm occluded by embolization with Gelfoam. The patient recovered uneventfully from these procedures.
Key Words: Blunt head injury; Epistaxis; Traumatic aneurysm; Internal carotid artery; External carotid artery; Embolization
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