Post-traumatic Pseudoaneurysm of the Internal Carotid Artery with Intractable Epistaxis: A Case Report

Abstract

Epistaxis is a common otorhinolaryngology emergency. There are several treatment modalities for epistaxis, but bleeding from the internal carotid artery necessitates a particular treatment technique. We report a case of a 22-years old man who presented to us recurrent episodes of epistaxis and blurry vision in the right eye for one month. The patient had undergone maxillo-facial surgery following a road traffic accident one year back. Bleeding episodes were occasionally severe with blood loss of up to 800 to 1000ml. These  episodes were managed conservatively with posterior nasal packing and frequent blood transfusions. A computed tomography-angiography revealed a pseudoaneurysm arising from the cavernous segment of the right internal carotid artery which was managed successfully by embolization of the aneurysm sac with coils. Despite the rarity of internal carotid artery pseudoaneurysm in individuals with a history of trauma, doctors must be aware of the possibility. Timely identification and treatment of a pseudoaneurysm can save a person's life.