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Giant petrous carotid aneurysm: persistent epistaxis despite internal carotid artery ligation

Published online by Cambridge University Press:  13 June 2008

H Singh ,
J Thomas ,
W L E Hoe  and
D S Sethi
H Singh*
Affiliation:
Department of Otolaryngology, Singapore General Hospital, Singapore
J Thomas
Affiliation:
Department of Neurosurgery, National Neuroscience Institute, Singapore General Hospital, Singapore
W L E Hoe
Affiliation:
Department of Diagnostic Radiology, Singapore General Hospital, Singapore
D S Sethi
Affiliation:
Department of Otolaryngology, Singapore General Hospital, Singapore
*
Address for correspondence: Dr Harvinder Singh, Consultant Otolaryngologist, Rhinology Fellow, Otolaryngology Department, Singapore General Hospital, Outram Road, 169608Singapore. Fax: 6226 2079 E-mail: [email protected]
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Abstract

Objectives:

We report a rare case of giant petrous carotid aneurysm.

Method:

Case report and a review of the literature regarding treatment options for such aneurysms.

Results:

A 30-year-old man presented with epistaxis, headaches and visual disturbance. Definitive diagnosis was achieved by non-invasive imaging techniques, including magnetic resonance angiography and carotid angiography. Carotid angiography demonstrated a giant petrous carotid aneurysm effacing the petrous apex. The aneurysm was obliterated by internal carotid artery ligation, following successful tolerance of the balloon occlusion test. However, despite internal carotid artery ligation, this patient continued to have minor episodes of epistaxis.

Conclusion:

Some aneurysms are too large to be treated with endovascular occlusion techniques; in such cases, ligation of the parent vessel is indicated. However, our patient continued to experience persistent, mild epistaxis despite internal carotid artery ligation, as a result of the reperfusion phenomenon.

Keywords

Internal Carotid ArteryEpistaxisAneurysmTemporal Bone
Type
Online Only Clinical Record
Information
The Journal of Laryngology & Otology , Volume 122 , Issue 8 , August 2008 , e18
Copyright
Copyright © JLO (1984) Limited 2008

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