Journal of Cerebrovascular and Endovascular Neurosurgery

Korean Society of Cerebravascular Surgeons (대한뇌혈관외과학회)
권호 표지

Technical Pitfalls in the Endovascular Treatment of Traumatic Pseudoaneurysm of the Internal Carotid Artery : Case Report

  • Jung, Young Jin (Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Ahn, Jae Sung (Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kwon, Do Hoon (Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kwun, Byung Duk (Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine)
  • Published : 2011.09.30
⟨ Previous Next ⟩

Abstract

A posttraumatic pseudoaneurysm of the internal carotid artery (ICA) is a rare cause of massive epistaxis, and this can be fatal. Treating a ruptured traumatic pseudoaneurysm of the cavernous ICA is challenging as the treated patient has the same risk profile as an untreated patient if the procedure results in only incomplete occlusion. For this reason, additional procedures need to be performed for these cases. The present report describes two cases of a traumatic ICA pseudoaneurysm that was only partially occluded by endovascular balloon placement because an external carotid-ophthalmic artery anastomosis was not detected. The patients were immediately and successfully treated by performing surgical clipping of the ICA.

Keywords

References

  1. Araki C, Handa H, Handa J, Yoshida K. Traumatic aneurysm of the intracranial extradural portion of the internal carotid artery. Report of a case. J Neurosurg 23:64-7, 1965 https://doi.org/10.3171/jns.1965.23.1.0064
  2. Chambers EF, Rosenbaum AE, Norman D, Newton TH. Traumatic aneurysms of cavernous internal carotid artery with secondary epistaxis. AJNR Am J Neuroradiol 2:405-9, 1981
  3. Chen D, Concus AP, Halbach VV, Cheung SW. Epistaxis originating from traumatic pseudoaneurysm of the internal carotid artery: diagnosis and endovascular therapy. Laryngoscope 108:326-31, 1998 https://doi.org/10.1097/00005537-199803000-00004
  4. Crow WN, Scott BA, Guinto FC Jr., Chaljub G, Wright G, Rabassa AE et al. Massive epistaxis due to pseudoaneurysm. Treated with detachable balloons. Arch Otolaryngol Head Neck Surg 118:321-4, 1992 https://doi.org/10.1001/archotol.1992.01880030113023
  5. Ding MX. Traumatic aneurysm of the intracavernous part of the internal carotid artery presenting with epistaxis. Case report. Surg Neurol 30:65-7, 1988 https://doi.org/10.1016/0090-3019(88)90182-6
  6. Ferguson GG, Drake CG. Carotid-ophthalmic aneurysms: the surgical management of those cases presenting with compression of the optic nerves and chiasm alone. Clin Neurosurg 27:263-307, 1980 https://doi.org/10.1093/neurosurgery/27.CN_suppl_1.263
  7. Fox AJ, Vinuela F, Pelz DM, Peerless SJ, Ferguson GG, Drake CG et al. Use of detachable balloons for proximal artery occlusion in the treatment of unclippable cerebral aneurysms. J Neurosurg 66:40-6, 1987 https://doi.org/10.3171/jns.1987.66.1.0040
  8. Goleas J, Mikhael MA, Paige ML, Wolff AP. Intracavernous carotid artery aneurysm presenting as recurrent epistaxis. Ann Otol Rhinol Laryngol 100:577-9, 1991 https://doi.org/10.1177/000348949110000711
  9. Han MH, Sung MW, Chang KH, Min YG, Han DH, Han MC. Traumatic pseudoaneurysm of the intracavernous ICA presenting with massive epistaxis: imaging diagnosis and endovascular treatment. Laryngoscope 104:370-7, 1994
  10. Higashida RT, Halbach VV, Dowd CF, Barnwell SL, Hieshima GB. Intracranial aneurysms: interventional neurovascular treatment with detachable balloons--results in 215 cases. Radiology 178:663-70, 1991 https://doi.org/10.1148/radiology.178.3.1994399
  11. Lee DH, Hur SH, Choi SJ, Jung SM, Ryu DS, Park MS et al. A recurred carotid siphon pseudoaneurysm after detachable coil embolization. Successful endovascular management with detachable balloons. Interv Neuroradiol. 8:61-5, 2002 https://doi.org/10.1177/159101990200800111
  12. Matsuda H, Higashi S, Asli IN, Eftekhari M, Esmaili J, Seki H et al. Evaluation of cerebral collateral circulation by technetium- 99m HM-PAO brain SPECT during Matas test: report of three cases. J Nucl Med 29:1724-9, 1988
  13. Wilms G, Demaerel P, Lagae L, Casteels I, Mombaerts I. Direct caroticocavernous fistula and traumatic dissection of the ipsilateral internal carotid artery: endovascular treatment. Neuroradiology 42:62-5, 2000 https://doi.org/10.1007/s002340050016