Mankahla Ncedile, LeFeuvre David, Taylor Allan
1 Department of Neurosurgery, Groote Schuur Hospital and University of Cape Town, South Africa.
2 Division of Neurointerventional and Cerebrovascular Surgery, Groote Schuur Hospital and University of Cape Town, South Africa.
Interv Neuroradiol. 2017 Aug;23(4):387-391. doi: 10.1177/1591019917706053. Epub 2017 May 9.
Introduction Blunt head trauma can injure the cavernous segment of the internal carotid artery (ICA). This may result in a carotid cavernous fistula (CCF). Rarely, a traumatic aneurysm may bleed medially causing massive epistaxis. Case presentation We present two cases of traumatic intracavernous carotid pseudoaneurysms with delayed massive epistaxis. The patients were managed with endovascular treatment involving coil embolization with parent vessel sparing and detachable balloon occlusion with carotid sacrifice. Early clinical outcome was good in both patients. Wherever possible, the CARE guidelines were followed in the reporting. Conclusion These cases illustrate the delayed nature of traumatic aneurysms and the need for a high index of suspicion in the presence of skull base fractures. The use of endovascular detachable balloon occlusion and coil embolization treatment with parent vessel preservation is shown.
引言 钝性头部外伤可损伤颈内动脉（ICA）海绵窦段。这可能导致颈内动脉海绵窦瘘（CCF）。极少情况下，外伤性动脉瘤可向内侧出血导致大量鼻出血。病例报告 我们报告两例外伤性海绵窦段颈内动脉假性动脉瘤伴延迟性大量鼻出血的病例。患者接受了血管内治疗，包括保留载瘤血管的弹簧圈栓塞和牺牲颈动脉的可脱性球囊闭塞。两名患者的早期临床结果均良好。在报告过程中尽可能遵循了CARE指南。结论 这些病例说明了外伤性动脉瘤的延迟性以及在存在颅底骨折时需要高度怀疑。展示了使用血管内可脱性球囊闭塞和保留载瘤血管的弹簧圈栓塞治疗。
