Posttraumatic Internal Carotid Artery Pseudoaneurysm: Endovascular Management by Stent–Graft Placement

Abstract

Intracavernous internal carotid artery (ICA) pseudoaneurysms are extremely rare among isolated sphenoid fractures. We report a case of a 28-year-old man who suffered from neurotrauma due to a fall of the ceiling fan over the head and subsequently developed headache with recurrent episodes of profuse epistaxis for the next 10 days. Magnetic resonance angiography revealed a large pseudoaneurysm involving intracavernous ICA. The patient underwent emergent digital subtraction angiography and a covered stent graft was used to reconstruct the ICA. Patient was discharged 5 days later completely asymptomatic and was called up for follow-up after 3 months. This case report highlights the importance of high index of suspicion of vascular injury and emergent endovascular treatment to prevent mortality in base of skull fractures.

Keywords

intracavernous internal carotid artery - stent graft - epistaxis - pseudoaneurysm

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