Abstract
A giant, wide-necked pseudoaneurysm of the cavernous internal carotid artery (ICA) was found in a 17-year-old male patient who had suffered a high impact car accident. Four months after the accident, he presented with diplopia and facial pain associated with severe epistaxis. Coil occlusion of the aneurysm was performed and stopped the bleeding. One week later, a control DSA was carried out. Recanalization of the aneurysm due to coil compaction was observed, for which a Pipeline Embolization Device was implanted. The patient had a complete clinical recovery, and follow-up examinations confirmed aneurysm occlusion. Two years later, he presented to the emergency department with a coil protruding through his nostril. The actions taken following this event are explained below. The management of posttraumatic cavernous ICA aneurysms is the main topic of this chapter.
This is a preview of subscription content, log in via an institution to check access.
References
Aoun SG, Rahme RJ, El Ahmadieh TY, Bendok BR, Hunt Batjer H. Incorporation of extruded coils into the third nerve in association with third nerve palsy. J Clin Neurosci. 2013;20(9):1299–302. https://doi.org/10.1016/j.jocn.2012.10.040.
Chaboki H, Patel AB, Freifeld S, Urken ML, Som PM. Cavernous carotid aneurysm presenting with epistaxis. Head Neck. 2004;26(8):741–6. https://doi.org/10.1002/hed.20081.
Chen D, Concus AP, Halbach VV, Cheung SW. Epistaxis originating from traumatic pseudoaneurysm of the internal carotid artery: diagnosis and endovascular therapy. Laryngoscope. 1998;108(3):326–31.
Chow MW, Chan DT, Boet R, Poon WS, Sung JK, Yu SC. Extrusion of a coil from the internal carotid artery through the middle ear. Hong Kong Med J. 2004;10(3):215–6.
Dedmon M, Meier J, Chambers K, Remenschneider A, Mehta B, Lin D, Yoo AJ, Curry W, Gray S. Delayed endovascular coil extrusion following internal carotid artery embolization. J Neurol Surg Rep. 2014;75(2):e255–8. https://doi.org/10.1055/s-0034-1387193.
Mohan B, Singal S, Bawa AS, Mahindra P, Yamin M. Endovascular management of traumatic pseudoaneurysm: short & long term outcomes. J Clin Orthop Trauma. 2017;8(3):276–80. https://doi.org/10.1016/j.jcot.2017.05.010.
Nasi D, Dobran M , di Somma L, Di Rienzo A, De Nicola M, lacaangeli M. Coil extrusion into the naso- and oropharynx ten years after internal carotid artery pseudoaneurysm embolization: a case report. Case Rep Neurol. 2019;11(1):4–9. https://doi.org/10.1159/000496283.
Singh A, Sikka K, Jain N, Devarajan LJ. Delayed endovascular coil extrusion presenting as a foreign body of the throat: a case report. Neurointervention. 2018;13(1):66–9. https://doi.org/10.5469/neuroint.2018.13.1.66.
Sirakov S, Panayotova A, Sirakov A, Minkin K, Hristov H. Delayed intranasal coil extrusion after internal carotid artery pseudoaneurysm embolization. Interv Neuroradiol. 2019;25(2):139–43. https://doi.org/10.1177/1591019918805151.
Sridharan R, Low SF, Mohd MR, Kew TY. Intracavernous internal carotid artery pseudoaneurysm. Singap Med J. 2014;55(10):e165–8. https://doi.org/10.11622/smedj.2014148.
Struffert T, Buhk JH, Buchfelder M, Rohde V, Doerfler A, Knauth M. Coil migration after endovascular coil occlusion of internal carotid artery pseudoaneurysms within the sphenoid sinus. Minim Invasive Neurosurg. 2009;52(2):89–92. https://doi.org/10.1055/s-0029-1215579.
Wang T, Zhang C, Xie X. Delayed coil migration after treatment of traumatic pseudoaneurysm. World Neurosurg. 2018;113:206–7. https://doi.org/10.1016/j.wneu.2017.12.040.
Wilseck Z, Savastano L, Chaudhary N, Pandey AS, Griauzde J, Sankaran S, Wilkinson D, Gemmete JJ. Delayed extrusion of embolic coils into the airway after embolization of an external carotid artery pseudoaneurysm. J Neurointerv Surg. 2018;10(7):e18. https://doi.org/10.1136/neurintsurg-2017-013178.rep.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2020 Springer Nature Switzerland AG
About this entry
Cite this entry
Lylyk, I., Viso, R., Scrivano, E., Lundquist, J., Lylyk, P. (2020). Cavernous Internal Carotid Artery Aneurysm: Giant Posttraumatic Carotid Cavernous Pseudoaneurysm, Presenting with Epistaxis; Treated in Two-Stage Strategy with Complete Occlusion and Delayed Coil Extrusion Through the Nostril. In: Henkes, H., Lylyk, P., Ganslandt, O. (eds) The Aneurysm Casebook. Springer, Cham. https://doi.org/10.1007/978-3-319-70267-4_167-1
Download citation
DOI: https://doi.org/10.1007/978-3-319-70267-4_167-1
Received:
Accepted:
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-70267-4
Online ISBN: 978-3-319-70267-4
eBook Packages: Springer Reference MedicineReference Module Medicine