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Epistaxis Related to Internal Carotid Artery Cavernous Sinus Aneurysm

Bibek Gyanwali, Hongquan Wu, Meichan Zhu, Anzhou Tang

Background: Nasal bleeding is one of the most common clinical presentation in the Otolaryngology Department. Epistaxis related to internal carotid artery aneurysm is a rare cause of epistaxis. In this case we report a case of recurrent epistaxis for more than 7 months in a previously healthy Chinese man.

Case report: Patient complained recurrent nasal bleeding for seven months without any inducing factors, with no history of trauma to the nose, congestive heart failure, diabetes mellitus, hypertension and other diseases. Head and neck computed tomography revealed left maxillary sinus, sphenoid sinus and the right frontal sinus inflammation and nasal septum deviation to the right. Head and neck angiography revealed left internal carotid artery cavernous sinus aneurysm.

Conclusion: Epistaxis related to internal carotid artery aneurysm is quite rare but it is important to consider aneurysms in the etiology of epistaxis. Which may be fatal if the cause of nasal bleeding cannot be identified. We managed our patiently conservatively using nasal packing, hemostatic, anti-inflammatory drugs. The aneurysm was managed by using stent.