1/62. Non-traumatic aneurysms of the cavernous sinus causing massive epistaxis--report of three cases.Three cases of non-traumatic intracavernous aneurysms that gave rise to massive epistaxis and required operative intervention, are reported. This is a rare but serious cause of epistaxis, because delayed diagnosis and management can lead to repeated bleedings and even to death. It is important, therefore, to diagnose the source of epistaxis and treat it as soon as possible. In our three patients, an emergency angiography enabled us to diagnose an aneurysm in the cavernous sinus. These aneurysms were located in the C3 or C4 portion of the internal carotid artery and were 3-5 mm in diameter. The projections of these aneurysms were infero-medial, antero-inferior, and lateral, respectively. All three patients underwent emergent surgery. neck clipping of the aneurysm was performed in two patients, and gradual occlusion of the internal carotid artery in the third patient. Emergency surgery successfully prevented further episodes of epistaxis in all three patients.- - - - - - - - - - ranking = 1keywords = aneurysm (Clic here for more details about this article) |
2/62. Delayed epistaxis resulting from external carotid artery injury requiring embolization: a rare complication of transsphenoidal surgery: case report.OBJECTIVE AND IMPORTANCE: Delayed epistaxis resulting from trauma to branches of the external carotid artery is an infrequent but potentially serious complication of transsphenoidal surgery. We report two cases of severe, delayed epistaxis in patients who had undergone transsphenoidal surgery. In both cases, noninvasive treatment failed, necessitating endovascular intervention. CLINICAL PRESENTATION: The first patient, a 52-year-old woman with a prolactinoma, underwent a second transsphenoidal resection 18 months after the first surgery. She was readmitted on postoperative Day 15 with massive epistaxis. The second patient, a 40-year-old woman, had undergone two transsphenoidal surgeries, 14 years apart, for an adrenocorticotropic hormone-secreting adenoma. She was readmitted with massive epistaxis on postoperative Day 17. INTERVENTION: Both patients were initially treated with nasal balloon packing but experienced recurrent hemorrhage when the balloon was deflated, necessitating referral to the interventional radiology department for embolization. At arteriography, the first patient was found to have a pseudoaneurysm of the medial branch of the left internal maxillary artery, which was subsequently embolized. Arteriography in the second patient revealed an abnormally dilated midline branch of the right internal maxillary artery in the nasal septum; this vessel was occluded at arteriography. CONCLUSION: Delayed massive epistaxis is a rare but significant complication of transsphenoidal surgery. Injury to branches of the external carotid artery, along with injury to the internal carotid artery, should be suspected in patients who present with delayed epistaxis after transsphenoidal surgery. angiography performed in patients with refractory bleeding should include selective external carotid injections. epistaxis that is refractory to anterior and posterior nasal packing may be effectively treated with endovascular embolization.- - - - - - - - - - ranking = 0.67078269474479keywords = pseudoaneurysm, aneurysm (Clic here for more details about this article) |
3/62. Massive epistaxis after rupture of intracavernous carotid artery aneurysm. Case report.We present a case of massive epistaxis caused by an internal carotid artery aneurysm. The initial treatment with endovascular balloon embolization failed as a result of balloon displacement. After rebleeding, the intracavernous aneurysm was treated with an endovascular detachable balloon embolization technique, which resulted in cessation of epistaxis. The different treatment options for interventional radiology and management of ruptured carotid artery aneurysms are discussed.- - - - - - - - - - ranking = 0.77777777777778keywords = aneurysm (Clic here for more details about this article) |
4/62. Leber's miliary aneurysms associated with telangiectasia of the nasal mucosa.A 20-year-old woman, treated with cryopexy and xenon- and argon-laser photocoagulation for Leber's miliary aneurysms in her right eye, suffered from repeated epistaxis. She underwent an endoscopy that showed an unusual number of telangiectatic veins. Laboratory results and routine physical and neurologic examinations showed normal values. Dematologic examination revealed no signs of hereditary hemorrhagic telangiectasis (Osler's disease). Nevertheless, it seems reasonable to assume that the combination of microvascular disturbances in one eye and in the nasal mucous membrane is not a coincidental finding.- - - - - - - - - - ranking = 0.55555555555556keywords = aneurysm (Clic here for more details about this article) |
5/62. Evolution of incidentally-discovered fusiform aneurysms of the vertebrobasilar arterial system: neuroimaging features suggesting progressive aneurysm growth.This study investigated the natural history and biological behavior of incidental fusiform aneurysms in four patients with incidental fusiform aneurysms of the vertebrobasilar arterial system who had been followed up for more than 3 years (mean 3.5 years). Two lesions remained the same size, and two lesions gradually grew. angiography showed the non-growing fusiform aneurysms as a circumferentially or unilaterally fusiform dilatation of a short segment of the vertebral artery with smooth walls and a steep slope of the dilatation, and the growing fusiform aneurysms as unilaterally fusiform involving a long segment of the vertebral artery or basilar artery with irregular walls and a gentle slope of dilatation. Magnetic resonance (MR) imaging demonstrated the non-growing fusiform aneurysms as a signal-void area, and the growing fusiform aneurysms as high and intermediate signals in addition to the normal flow void. The heterogeneous MR intensities probably correspond to turbulent flow, laminar flow, thrombosis, or intramural hematoma. Differentiation of growing and non-growing fusiform aneurysms is very difficult at the initial diagnosis. However, enlargement of the fusiform aneurysms is consistent with hemorrhage into the aneurysmal wall, which is confirmed by MR imaging. Fusiform aneurysms with the characteristics of the growing aneurysms cannot be overlooked because of the potential to develop into giant fusiform aneurysms which are very difficult to manage therapeutically.- - - - - - - - - - ranking = 2.2222222222222keywords = aneurysm (Clic here for more details about this article) |
6/62. Giant cervical internal carotid artery pseudoaneurysm in a child: endovascular treatment.We report a child with a giant upper cervical internal carotid artery pseudoaneurysm presenting with dysphagia, respiratory distress and a sentinel mild epistaxis, then massive epistaxis. rupture of the pseudoaneurysm during treatment occurred, as in one reported case. Prompt endovascular treatment yielded a good outcome.- - - - - - - - - - ranking = 4.0246961684688keywords = pseudoaneurysm, aneurysm (Clic here for more details about this article) |
7/62. epistaxis due to traumatic internal carotid artery aneurysm.epistaxis due to internal carotid artery (ICA) trauma is uncommon, and that due to aneurysm of the artery is rarer still. Most cases result in fatality due to severe, uncontrolled blood loss. The ICA is vulnerable to oropharyngeal trauma as it ascends beside the lateral pharyngeal wall. We describe a case of an 11-month-old girl who sustained oropharyngeal wall trauma from the handle of a wooden spoon. After a characteristic latent period of several days, upper airway obstruction occurred due to a right parapharyngeal mass, which extended inferiorly to the level of the larynx. angiography confirmed a large dissecting ICA aneurysm. This was treated successfully by radiological coil occlusion.- - - - - - - - - - ranking = 0.66666666666667keywords = aneurysm (Clic here for more details about this article) |
8/62. An unusual epistaxis.The case of a man who presented complaining of epistaxis is reported. He had coarctation repair 18 years previously. Subsequent investigation revealed an aortobronchial fistula resulting from false aneurysm formation distal to the original vessel anastamosis. This was repaired at surgery, the patient suffering a minor stroke, before rehabilitation and good recovery.- - - - - - - - - - ranking = 0.11111111111111keywords = aneurysm (Clic here for more details about this article) |
9/62. A case of internal carotid artery aneurysm diagnosed on basis of massive nosebleed.The authors report a rare case of a nontraumatic giant internal carotid aneurysm which ruptured into the nasal cavity, causing massive rhinorrhagia in a 64-year-old Japanese woman. CT images of the head revealed an aneurysm having a diameter of about 5 cm with a neighboring area of erosion of the anterior base of the skull, and a swelling extending to inside the sphenoidal sinuses. Cerebal angiography resulted in a diagnosis of a giant aneurysm of the left internal carotid artery. Coil embolization and other surgical treatments were recommended, but the patient's family refused to consent and requested only conservative therapy. The natural course of the patient was thus followed, and the patient died after repeated episodes of aneurysm rupture and massive nosebleeds. It was concluded that curative therapy should be administered as soon possible upon diagnosis of this disease.- - - - - - - - - - ranking = 0.88888888888889keywords = aneurysm (Clic here for more details about this article) |
10/62. Severe epistaxis caused by traumatic aneurysm of cavernous carotid artery.A case of cavernous carotid aneurysm presented with unilateral blindness, orbital fracture and recurrent, severe epistaxis of delayed onset. Traumatic origin of aneurysm is confirmed by repeat angiographic studies.- - - - - - - - - - ranking = 0.66666666666667keywords = aneurysm (Clic here for more details about this article) |
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