Cases reported "Epistaxis"

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1/42. The use of nasal endoscopy to control profuse epistaxis from a fracture of the basi-sphenoid in a seven-year-old child.

    A seven-year-old child sustained a fracture of her basisphenoid resulting in profuse, life-threatening haemorrhage which could not be controlled with a post-nasal pack. The fracture site was identified using rigid endoscopy and packed with oxidized cellulose, resulting in immediate control of the haemorrhage. The use of the nasal endoscope in the management of posterior epistaxis is discussed.
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ranking = 1
keywords = fracture
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2/42. life-threatening haemorrhage after elevation of a fractured zygoma.

    A 21-year-old man presented with a fractured left zygoma after an alleged assault. The fracture was elevated four days later, at which time he had a brisk left-sided epistaxis. Recovery was uneventful except for a haematoma that was drained a month later. Two weeks after this, he was admitted after having collapsed. He was shocked and bleeding profusely from his nose. He had a further major bleed in hospital and this was treated by tying off the left external carotid artery. He has made an uneventful recovery and investigations have shown no bleeding diathesis.
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ranking = 1
keywords = fracture
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3/42. Barotraumatic blowout fracture of the orbit.

    We report a rare case of a barotraumatic blowout fracture of the orbit. A 32-year-old woman presented with sudden swelling of the right orbital region after vigorous nose blowing. Computed tomography scan revealed a blowout fracture of the medial wall of the right orbit with orbital emphysema and herniation of the orbital soft tissue. She was treated with prednisolone and an antibiotic, and did not show diplopia or visual disturbance. Three different theories have so far been proposed to explain the mechanism of blowout fractures, globe-to-wall contact theory, hydraulic theory, and bone conduction theory. The present case indicates that blowout fractures of the orbit can be induced solely by a sudden change of pressure, thereby suggesting the validity of the hydraulic theory.
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ranking = 1.3333333333333
keywords = fracture
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4/42. Endovascular particulate and alcohol embolization for near-fatal epistaxis from a skull base vascular malformation.

    A three-year old girl who initially presented at 16 months with epistaxis from an anterior skull base vascular anomaly returned with near-fatal epistaxis despite embolization of the internal maxillary artery at the time of initial presentation. Repeat angiography demonstrated blood supply to the vascular lesion coming from branches of both the external and internal carotid arteries. The patient underwent four sessions of endovascular embolization with polyvinyl alcohol, alcohol, and gelatin microspheres. At the conclusion of treatment, her epistaxis had resolved and the only residual blood supply to the lesions came from bilateral ophthalmic arteries intentionally not sacrificed to prevent loss of vision. Endovascular embolization of both the internal and external carotid arteries is a challenging but important treatment option for life-threatening epistaxis resulting from vascular lesions of the skull base.
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ranking = 0.5798325502434
keywords = skull
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5/42. A rare clival and sellar fracture with pneumatocephalus.

    We present a case of clival and sellar complex fracture produced by an indirect mechanism. This previously healthy patient had an occipital trauma followed by epistaxis. CT showed a clival and sellar fracture with pneumatocephalus. The probable fracture mechanism was contre-coup injury, linked to cerebral shock-wave transmission. This type of fracture is generally observed in the anterior part of the skull base, in a low resistance area. Severe osteoporosis probably accounted for the unusual fracture site in this patient. A mechanism of direct clival transmission is discussed, together with the usual complications of sphenoid injuries.
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ranking = 1.5966387583739
keywords = fracture, skull
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6/42. Endoscopic repair of posttraumatic enophthalmos using medial transconjunctival approach: a case report.

    A blowout fracture of the medial orbital wall should be suspected when periorbital trauma results in epistaxis, orbital hemorrhage, horizontal dysmotility or dystopia of the globe, and/or orbital emphysema. Large medial orbital wall blowout fractures are frequently complicated by posttraumatic enophthalmos. Clinicians should consider a medial transconjunctival approach for repair of these fractures when surgical repair is indicated by a comprehensive clinical and radiologic orbital evaluation. Excellent cosmetic and functional results can be achieved through the use of an extended transcaruncular incision, rigid endoscope, and high-density porous polyethylene implant placement. The technique can be used in the early, delayed, and late stages of medial orbital wall blowout fracture repair. The technique can be used alone in isolated medial orbital wall fractures or combined with other craniofacial approaches.
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ranking = 0.83333333333333
keywords = fracture
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7/42. air-fluid levels in the sphenoid sinus in epistaxis and nasal packing.

    air-fluid levels in the sphenoid sinus have been described in association with skull fracture, cerebrospinal fluid rhinorrhea, and sinusitis. The authors have observed this sign in the absence of significant trauma in patients with epistaxis and nasal packing. The fluid is probably normal sinus secretion retained due to prolonged recumbency, although other explanations for its accumulation are discussed.
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ranking = 2.2420329348681
keywords = skull fracture, fracture, skull
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8/42. 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.
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ranking = 0.0966387583739
keywords = skull
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9/42. 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.
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ranking = 0.16666666666667
keywords = fracture
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10/42. Massive epistaxis related to petrous carotid artery pseudoaneurysm after radiation therapy: emergency treatment with covered stent in two cases.

    Two patients had acute left carotid rupture from radiation therapy-induced pseudoaneurysms, resulting in hemodynamic collapse. Because the patients were semicomatose and in shock, an immediate salvage procedure was needed. Location of the pseudoaneurysm at the skull base made surgical treatment less possible. Endovascular therapy was the treatment of choice. Preserving patency of the carotid artery was a desirable option. The successful use of a covered stent in the emergency treatment of massive epistaxis due to active bleeding from pseudoaneurysm in the petrous internal carotid artery (ICA) is described.
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ranking = 0.0966387583739
keywords = skull
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