Posttraumatic Internal Carotid Artery Pseudoaneurysm: Endovascular Management by Stent–Graft Placement

Abstract

Intracavernous internal carotid artery (ICA) pseudoaneurysms are extremely rare among isolated sphenoid fractures. We report a case of a 28-year-old man who suffered from neurotrauma due to a fall of the ceiling fan over the head and subsequently developed headache with recurrent episodes of profuse epistaxis for the next 10 days. Magnetic resonance angiography revealed a large pseudoaneurysm involving intracavernous ICA. The patient underwent emergent digital subtraction angiography and a covered stent graft was used to reconstruct the ICA. Patient was discharged 5 days later completely asymptomatic and was called up for follow-up after 3 months. This case report highlights the importance of high index of suspicion of vascular injury and emergent endovascular treatment to prevent mortality in base of skull fractures.