Department of Neuroimaging and Interventional Neuroradiology, Upendra Devkota Memorial National Institute of Neurological and Allied Sciences, Kathmandu, Nepal.
Department of Critical Care Medicine, Grande International Hospital, Kathmandu, Nepal.
JNMA J Nepal Med Assoc. 2022 Feb 15;60(246):218-221. doi: 10.31729/jnma.5860.
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.
鼻出血是耳鼻喉科常见的急症。有几种治疗鼻出血的方法,但颈内动脉出血需要特殊的治疗技术。我们报告了一例 22 岁男性患者,他因右眼球视力模糊和反复鼻出血 1 个月来就诊。该患者在一年前的一次交通事故后面部接受了颌面外科手术。出血发作偶尔会很严重,出血量达 800 至 1000ml。这些发作通过后鼻孔填塞和频繁输血进行保守治疗。计算机断层血管造影显示右侧颈内动脉海绵窦段假性动脉瘤,用线圈成功栓塞动脉瘤囊。尽管创伤后颈内动脉假性动脉瘤在个体中较为罕见,但医生必须意识到这种可能性。及时识别和治疗假性动脉瘤可以挽救生命。