Endovascular occlusion of cavernous ICA in massive life threatening epistaxis: Case report

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Rahul Srinivasan

Medical Trust Hospital, India

: J Spine Neurosurg

Abstract

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Massive delayed epistaxis following craniofacial trauma from internal carotid artery pseudoaneurysm is a rare but potentially fatal complication. Here we present a case of 18 year male who came to us with intermittent self-limiting spells of epistaxis associated with brief spells of unconsciousness. Patient had a past history of motor vehicle accident before one month during which the patient had sustained a sphenoid fracture. CT brain did not reveal any presence of intracranial bleed. Patient was then subjected to a nasal endoscopy which did not reveal any significant abnormality. Later same day, patient became unresponsive after an episode massive epistaxis with hypovolemic shock. He was resuscitated and was immediately subjected to DSA, which revealed an internal carotid artery pseudoaneurysm with contrast leak into the sphenoid sinus. Here, in presence of good collateral circulation the patient underwent complete occlusion of the cavernous ICA segment of aneurysm. At 6 weeks follow up the patient remains asymptomatic.

Biography

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Rahul Srinivasan is a Resident in Neurosurgery Department at Medical Trust Hospital, Kochi, Kerala. He is also a Member of Cochin Neurological Society and Neurological Society of India. He has co-authored various articles in field of neurotrauma. During his post-graduation he has assisted multiple cranial, spinal surgeries and endovascular procedure. His current research also continues in field of neurotrauma.

E-mail: rahulmulund@gmail.com