Cause Of Epistaxis Research Articles

Unnoticed freshwater leech as a hidden cause for recurring epistaxis: a case series and review of literature conducted at Tertiary Care Hospital Sikkim, North East India

BackgroundWhile leeches as intranasal foreign bodies are not frequently encountered, they can be one of the causes of epistaxis. The aim of the study is to raise awareness among healthcare professionals about the possibility of patients from leech endemic regions presenting with epistaxis.Case presentationWe present a series of epistaxis cases due to intranasal leech infestation. In our series of 10 cases, there were 7 male and 3 female patients, aged between 2 and 53 years old. The duration of the complaint ranged from 1 to 5 weeks. All patients experienced with blood-stain nasal discharge or frank nasal bleeding at some point and most of them have a history of leech infestation from spring water as a local source. This article presents our approach to managing nasal leech infestation as epistaxis and outlines the precautionary measures taken for the retrieval of this living foreign body.ConclusionDetails of the history must be taken before concluding the diagnosis. Maintain a high index of suspicion of leech infestation as a hidden cause of epistaxis especially in patients coming from endemic areas.

Demographic Profile and Etiology of Epistaxis

Epistaxis is common worldwide otorhinolaryngology emergency presenting as a life-threatening condition especially in resource-constrained hospitals with limited health-care facilities for acceptable management. The aim of this study is to find out the common causes of epistaxis. It was a cross sectional study. It was carried out on 304 patients who presented with epistaxis at tertiary care hospital of Central India (Peoples College of Medical Science & Research Centre, Bhopal). It was found that among 304 participants, maximum number of patients with epistaxis were of age group 21–30 years i.e. 66 (21.71%) with 210 (69.08%) were male and 94 (30.92%) were female. It was found that maximum patients were of nose picking i.e. 113 (37.17%) followed by trauma via accident, assault and fall i.e. 77 (25.33%), followed by hypertension i.e. 49. Epistaxis is a common emergency condition in Otorhinolaryngology. People of all ages can be affected. Hypertension and trauma were the most common etiological/risk factors among the patients in whom etiology was found although in most of the patients etiology could not be found.

Pediatric Epistaxis-Effectiveness of Conservative Management.

Epistaxis is an emergency medical condition that sometimes requires admission to the emergency department. Pediatric epistaxis differs from epistaxis in the older population in terms of etiology, severity, and management. Our objective was to identify the distinctive features of pediatric epistaxis and determine the appropriate management. This was a retrospective study of 231 medical records of children (<18 years old) with epistaxis of a total of 1171 cases in the general population who presented to our medical center's emergency department between 2013 and 2018. Among 231 admissions, 10 children (4.3%) presented more than once. Male patients accounted for the majority of cases (64.5%), and the average age was 9.4 years. Two children were treated with aspirin because of cardiac valve disease. Anterior bleeding was detected in 101 cases (43.7%), whereas posterior origin was observed in 8 cases (3.5%). In 122 cases (52.8%), there was no active bleeding observed. Nose injury was the cause of epistaxis in 24 cases (10.4%), and 16 admissions (6.9%) followed nasal surgical interventions. Nineteen children (8%) had abnormal coagulation tests, and 7 patients (3%) received blood transfusions. Chemical cauterization was performed in 89 cases (39.3%), and anterior packing was needed in only 9 cases (3.9%). Nine children required hospitalization (3.9%), and 2 needed surgical intervention to control bleeding. Compared with the adult population, there were significantly fewer cases of active bleeding, recurrent epistaxis, anterior packing, or need for hospitalization in the pediatric population. Epistaxis is significantly less severe in the pediatric population, with only a few cases requiring major intervention. Endoscopic examination of the entire nasal cavity and routine coagulation tests are not mandatory unless there is a history of recurrent epistaxis, known coagulopathy, antiplatelet/anticoagulation therapy, or a suspicion of juvenile idiopathic angiofibroma. We suggest using absorbable packs, which offer advantages over cauterization or nonabsorbable packs.

Nasal Disorders.

Nasal obstruction, rhinorrhea, and epistaxis are common presenting concerns in primary care clinics. Nasal disorders affect the quality of life for many children and families. Rarely, these complaints may represent a life-threatening condition among infant obligate nasal breathers or cases of unusual pathology. The most common causes of rhinorrhea and nasal obstruction vary by age and include physiologic, infectious, allergic, foreign body, irritant, and traumatic causes. Less commonly, children may have congenital malformations, sinonasal masses, or autoimmune disease. The most common causes of epistaxis are inflammatory, environmental, and traumatic causes and medication misuse, but rarely, children may have predisposing anatomic, hematologic, or vascular abnormalities or even sinonasal tumors. In this article, we provide a thorough review of the common nasal disorders treated every day in primary care clinics and mention briefly some of the rare but serious cases that may be overlooked without considering a full differential diagnosis.

Knowledge and practices of epistaxis in Eastern Tanzania: A cross-sectional study of an emergency in otorhinolaryngology

IntroductionIt's approximated that 60% of the population globally experience epistaxis during lifetime. Despite epistaxis being prevalent in Tanzania, there are limited studies that have explored experience of participants on epistaxis. This study aims to determine knowledge on the causes, first aid management and practices of epistaxis among patients attending a health facility in Eastern Tanzania MethodsA descriptive cross-sectional study was conducted where 371 participants aged 15 years and above were interviewed using structured questionnaires. Data was analyzed using Statistical Package of Social Sciences version 23. Chi-square tests were performed and a p-value <0.05 was considered to be statistically significant ResultsAbout two-thirds (60.9%) of the study participants had good knowledge of the causes of epistaxis. Majority of participants knew excessive nose manipulation (95.1%) to be the commonest cause of epistaxis and the least cause mentioned was chronic liver disease (24.8%). On the other hand, 77.6% of the participants had good knowledge while 22.4% had poor knowledge regarding first aid management of epistaxis. In this study, 328(88.4%) participants knew pressing the nose could stop epistaxis, while 164(44.2%) knew the best position to stop epistaxis and that is to tilt the head forward and those who had history of epistaxis, 150 (73.2%) out of 205 pinched the nose as the first aid. Similarly, 133(35.8%) participants thought cessation of smoking has effect on decreasing the occurrence of epistaxis. A significant association was noted between knowledge of first aid management of epistaxis and some socio-demographic characteristics such as age and educational level. There was also a significant association between knowledge of the causes of epistaxis and educational level. ConclusionMajority of the participants had good knowledge of the causes and first aid management of epistaxis.

Epistaxis and its management: A prospective study in a Teritiary Care Centre

Background: Epistaxis ( nose bleed) is one of the most common ear, nose and throat (ENT) emergencies that present to the tertiary care center. Management of Epistaxis is challenging and most are managed conservatively and some by surgical intervention. There is always a need to find the prevalence of Epistaxis and to identify the etiological factors in management of Epistaxis, by different methods such as medical treatment, anterior and posterior nasal packing, and surgical intervention that includes endoscopic cauterization, endoscopic arterial ligation, SMR and Nasal bone reduction. In our study we will determine the various etiologies of epistaxis and its management options. Methodology: A prospective study was done in the Department of ENT, for duration of 18 months, total of 70 patients of both genders in age group of 18 - 60 years with clinical features of nasal bleed were enrolled in the study, and were subjected to clinical examination and history regarding onset and predisposing factors. Patients who are willing to undergo investigations to identify the cause and treatment are enrolled for the study after obtaining the written informed consent. Results: A total of 70 patients were examined in this study. Males were affected more than females. The patients distribution across different age groups shows maximum at age of 46-60 years followed by 36-45 years. The most common cause was found to be trauma followed by hypertension, rhinosinusitis, deviated nasal septum and idiopathic. In most cases, anterior nasal bleeding was observed.Majority of the cases managed conservatively 71.5% while 28.5% patients required surgical intervention. Conclusion: The study on epistaxis and its management provides valuable insights into effective strategies for addressing this common medical condition. This study emphasizes the importance of a medical and surgical approaches based on the severity and underlying causes of epistaxis. Anterior epistaxis is more common than posterior bleeds. Majority of cases of epistaxis are manageable by conservative measures and only few require surgical intervention. Overall, this study contributes to the ongoing efforts to enhance our understanding of epistaxis and refine therapeutic approaches for better patient outcomes.

Role of nasal endoscopy in evaluation and management of epistaxis

Background: Epistaxis is the most common ENT emergency. The localization of bleeding site and its control in profuse epistaxis is of major concern for the ENT surgeon. Nasal endoscope has proved to be a boon for the otolaryngologist and is an important tool in diagnosing these bleeding points and their immediate management which reduces the incidence of nasal packing either anterior or posterior. Aim was to study the importance of nasal endoscopy in diagnosing the cause and site of epistaxis and managing them appropriately. Methods: It was a prospective study conducted in 187 patients of epistaxis visiting ENT emergency at SMGSH, Jammu after getting IEC clearance. Results: 139 (73.8%) had anterior and 48 (26.2%) posterior epistaxis. Dry nasal septum and mass lesions were the common local causes followed by deviated nasal septum. Anterior part of septum (little’s area) was the common site of bleeding followed by woodruff’s area. The overall success rate of diagnosing the local cause and site of epistaxis was 99% with nasal endoscopy and only 47% with combined anterior and posterior rhinoscopy. Thus, eliciting the importance of nasal endoscopy over conventional anterior and posterior rhinoscopy. Conclusions: Nasal endoscopy helps in detecting the site and cause of epistaxis and also aids in its appropriate management. It helps in endoscopic guided direct pressure packing, bipolar electrocautery, endoscopy assisted mass excision and endoscopic guided foreign body removal. However, nasal endoscopy is not a substitute for nasal packing.

Evaluation of the Factors Affecting of Epistaxis: A Study in a Tertiary Care Hospital, Dhaka.

Introduction: Epistaxis refers to the occurrence of bleeding from the nose or nasal cavity. It is widely recognized as one of the most common emergencies encountered in medical settings, particularly in the ear, nose, and throat departments, as well as in accident and emergency departments across the globe. The management of epistaxis depends on the severity of the bleeding and may involve various interventions, including conservative measures like nasal packing, cauterization techniques, or, in more severe cases, surgical interventions. Objective: The primary goal of this study was to investigate the various causes of epistaxis. Materials and Methods: This cross-sectional observational study was conducted at the Department of Otolaryngology and Head-Neck Surgery (ENT) in City Medical College &amp; Hospital from May 2021 to April 2023. The study involved 220 patients who presented with epistaxis complaints at the ENT Outpatient Department or Emergency unit of hospital. Diagnosis of the cases was based on their medical history, clinical examination, radiological and laboratory investigations. Result: 220 patients were studied during the period. The mean age ± standard deviation was determined to be 36.67 ± 18.06 years. The age range spanned from 1 to 85 years. Patients less than 25 years old were 124 (56.36%) and more than 25 years old were 96 (43.74%). Males (139) predominated in both indoor and outdoor patients with a male-to-female ratio of 1.7:1. The nasal cavity most involved was left 103 (47%) compared to right 85 (38.6%). Bilateral involvement was seen in 32 (14.4%) cases. Higher incidence was also noticed during winters 93 (42.1%), followed by summer 63 (28.7%), then autumn 38 (17.2%), and least in spring 26 (11.9%). The circadian rhythm was also noted where we found epistaxis to be more during night 82 (37.6%), followed by evening 78 (35.3%), and finally morning 60 (27.1%). Previous history of hypertension (HTN) is seen in 26.3% of cases (58). The history of taking medications with hemorrhagic risk currently or stopped within the last 10 days was 3.5% (8). We also found a relationship between the age group (&lt;25 years, &gt; 25 years) and the type of treatment. Conclusion: Epistaxis, or nosebleeds, can be caused by various factors such as trauma, inflammation, tumors, blood disorders, cardiovascular issues, and foreign bodies. Younger individuals are more prone to traumatic causes, while older individuals may experience more severe nosebleeds. Hypertension is a significant contributor, emphasizing the importance of blood pressure management. Understanding these diverse causes is crucial for effective treatment and prevention of potential complications. Medicine Today 2023 Vol.35(2): 124-128

Study of the kallikrein and prekallikrein content in the blood of patients with epistaxis

The problem of epistaxis has not lost its relevance for many years. The most common cause of epistaxis is hypertension. The purpose of the research was to study the kallikrein-kinin system in the blood of patients with single and recurrent epistaxis due to hypertension. The study of the kallikrein and prekallikrein content was carried out before and after graduated exercise, followed by the calculation of the coefficient of kallikrein formation. Initial activation of the kallikrein-kinin system was revealed in the patients of both groups. In the patients with single epistaxis, further activation of the kallikrein-kinin system after physical activity is observed, while in the patients with recurrent epistaxis, physical activity is not accompanied by a significant increase in its activity.

Study of etiopathogenesis and management of epistaxis in tertiary care centre

Background: Epistaxis is one of the most commonly addressed complaints in patients visiting outpatient department of ENT. This study aimed to determine common etiologies and management of epistaxis in a Tertiary care centre. Methods: This prospective descriptive study was conducted with 60 patients selected by consecutive sampling presented to our hospital with epistaxis between the years 2021-2022. Results: Incidence of epistaxis was more in males (58.33%) with male to female ratio of 1.4:1. Most common age group was between 10-49 years (68.33%). The commonest etiology was idiopathic (30%). When the cause was present, trauma was the most common reason mainly in young adults (13.33%) followed by hypertension (11.67%). The most common site of epistaxis was noted in the anterior nasal cavity (45%) where Little’s area (20%) was the most common location. Most cases were managed by conservative non-surgical treatments alone (55%) like anterior and, or posterior nasal packing, chemical/ electro-cauterization, foreign body removal, and blood components transfusion. Almost an equal number of patients underwent Surgical management in our hospital (45%) as it is a tertiary care centre. Conclusions: Epistaxis is an ENT emergency seen in all age groups, more common in adolescents and young adults, males are affected more than females. The cause of epistaxis was not known in most cases, i.e., Idiopathic. Most of the cases can be managed by non-surgical treatment. It is necessary for the treating doctor to accurately diagnose the etiology of the case, and bleeding site and treat accordingly.

Frequency of Etiological Factors Involved in patient of Epistaxis presenting at D.G Khan Hospital, D.G Khan

Objective: To determine the frequency of etiological factors involved in patient of epistaxis presenting at D.G Khan Hospital, D.G Khan. Study design: Cross sectional study Place and duration: Department of ENT, D.G Khan Hospital, D.G Khan from January 2022 to September 2022. Methodology: Total 167 patients with acute episode of nasal bleeding, either male or female, age between 10-60 years were recruited and etiological factors of episode were evaluated. Results: Total 167 patients with Epistaxis were selected. Mean age was 39.03 ± 14.97 years. Age range was 10-60 years, Males were 103 (62%) while females were 64 (38%). The commonest cause of epistaxis was idiopathic 86 (51.5%) cases, followed by nasal trauma 39 (23.4%), Nasopharyngeal carcinoma 11 (6.6%), sinusitis 9 (5.4%), tumors 5 (3%) bleeding disorder 8 (4.8%) and hypertension in 9 (5.4%) patients. Practical implication: Understanding the frequency of etiological factors involved in patients with epistaxis is a critical objective. The practical implications of this research could have significant benefits for the community: 1. Improved Clinical Practice: By determining the common causes of epistaxis, healthcare professionals can improve their diagnostic approach, providing more accurate and timely treatment, ultimately leading to better patient outcomes. 2. Early Intervention and Prevention: Understanding the etiological factors may enable the development of preventative strategies or early intervention approaches, potentially reducing the overall incidence of epistaxis. 3. Education and Awareness: This study could lead to increased public awareness about the common causes of epistaxis, encouraging individuals to take necessary precautions and seek early medical attention when needed. 4. Resource Allocation: Health resources could be better distributed based on the findings of this study, ensuring that facilities and personnel are adequately equipped to handle the most common causes of epistaxis. Overall, this study could substantially contribute to the community's overall health by enhancing the management and understanding of epistaxis. Conclusion: Results was present study showed that most common etiological factor of epistaxis was Idiopathic and nasal trauma was second in number. In most of cases, right nasal cavity was involved. Male were more victim of epistaxis as compared to females and epistaxis was commonly seen in 4th and 5th decade of life. Keywords: Epistaxis, Nosebleed, Idiopathic, etiology, nasal tumor, hypertension, nosebleed

Habitual epistaxis, associated with atrophic rhinitis

The article presents the results of a study of 27 patients aged 22 to 52 suffering from recurrent epistaxis. Patients who underwent surgical interventions in the nasal cavity, suffering from diabetes mellitus and other endocrine diseases, as well as persons working in hazardous industries were excluded from the number of those examined. No disturbances in the hemostasis system were revealed. The degree of the nasal mucosa damage was assessed by endoscopy and the rate of mucociliary clearance. The latter was determined using the saccharin test. Most often, the source of epistaxis was localized in the anterior sections of the nasal septum — in the Little area. Atrophic rhinitis was the local cause of epistaxis in 18 cases (64 %). Idiopathic epistaxis contributed for 36 % (9 cases). The most likely cause of the atrophic rhinitis in all cases was the climate adverse effect.

Leech infestation: Our experience at Government Medical College, Rajouri

Leech invasion into a bodily cavity or orifice is known as hirudiniasis. This article’s objective is to explain an uncommon cause of epistaxis brought on by a leech infestation in the nasal cavity, nasopharynx, or oropharynx in the hilly Rajouri district of Jammu and Kashmir, as well as how to manage it. This retrospective case series consisted of seven cases. All the cases present with unilateral epistaxis. Anterior rhinoscopy with or without endoscope reveal smooth, grayish-black mobile leech inside nasal cavity, nasopharynx, or oropharynx which was removed by suction or forcep.

Epistaxis as a marker of the unfavorable course of hypertension

The aim of this research was to study changes in the nasal mucosa vessels in hypertensive patients suffering from recurrent epistaxis. Patients and methods. 78 hypertensive patients aged between 50 and 70, admitted due to epistaxis, were studied. Diabetic, coagulopathic patients and those taking anticoagulants were excluded from the research. All the patients were divided into 2 groups: group 1 (46 people) with a single epistaxis, group 2 (32 people) with a recurrent epistaxis. At the admission, all the patients showed elevated blood pressure, yet the differences between the patients of group 1 and group 2 were not significant. 14 patients of group 2 did not reveal any source of hemorrhage due to a severely deviated septum. These patients underwent septoplasty followed by mucoperichondrium biopsy. Histological study of the samples showed multiple erosions within the epithelial layer, as well as necrotic patches spreading to the deeper mucous coat layers. The microvasculature showed dystrophic changes in the endothelium, its focal desquamation with basal membrane exposure and thrombocytes and erythrocytes adhesion at such places, erythrocyte aggregation, plasma separation, erythrocyte and fibrinous thrombi formation. Thus, the cause of epistaxis is not high blood pressure, but those changes in the nasal mucosa vessels promoted by long-term arterial hypertension.

Epistaxis etiology and treatment

Epistaxis occurs in approximately 60% of the general population. Every tenthperson requires treatment in a hospital setting. Epistaxis occurs in all age groups,reaching its peak in children around 10 years of age and in adults around 80years of age. The frequency and intensity of epistaxis are anatomically based onnumerous vascular connections. The cause of epistaxis in most cases can bedetermined on the basis of a detailed history and physical examination. Thereare a number of treatments available for nose bleeds. From widely availablemethods such as nasal tamponade to more advanced endovascular procedures.

Are laboratory evaluations required in every case admitted to the pediatric emergency department with epistaxis?

Epistaxis is a mostly self-limiting condition common among children and is rarely severe. In this study, it was aimed to evaluate the incidence, demographic characteristics, causes of bleeding and treatment methods of patients who presented to the pediatric emergency department (PED) with epistaxis, and to determine in which cases a laboratory test should be used. Admitted to Gazi University Faculty of Medicine, PED which provides trauma care and is a tertiary hospital, from 1 January 2019 to 31 December 2019, 452 patients aged 0-18 years who presented with epistaxis for any reason or secondary to systemic disease were analysed retrospectively. The annual incidence was found at 1.23%. The median age was 5.25 years, 258 of the cases (57.1%) were male. It was found that the cases most frequently applied to the hospital in the autumn months (37.6%). Sixty of the patients (13.3%) had a chronic disease and 54 (11.9%) had a history of drug use. Bleeding time was less than 5 minutes in 75.2% and 84.4% of the bleeding was unilateral. Nasal bleeding is local in 73.4%; 4.7% of them developed because of systemic reasons. The most common cause of epistaxis; while they were trauma at the first 10 years of age, they were idiopathic causes after the age of 10 years. In 434 (96%) of the patients, epistaxis spontaneously stopped and there was no need for additional treatment. As a result of this study, it was concluded that laboratory tests should be performed in cases with chronic disease history, bilateral bleeding, active bleeding and nontraumatic epistaxis. The situation that causes epistaxis in the childhood age group should be determined with a good history and physical examination, laboratory tests should not be used in every patient.

Epistaxis nose-bleed

Epistaxis is common condition of nose. It is often unilateral or bilateral. It’s rarely seen in infants and customary in males. Epistaxis could also be a symbol and not a disease and an attempt should find any local or constitutional cause. It’s often related to changes in temperature, humidity and in atmosphere. The causes of epistaxis are often divided into local, systemic, environmental, medication within the majority of some cases are idiopathic. Epistaxis are often classified by its anatomical location into anterior and posterior epistaxis. Anterior epistaxis is more common than posterior epistaxis. Flexible or rigid endoscopic examination, anterior and posterior endoscopy is beneficial for diagnostic purpose. Epistaxis is well managed with homoeopathic medicine.

Epistaxis in a Pediatric Outpatient Clinic: Could It be an Alarming Sign?

Introduction Epistaxis is a common presentation among children. Objective To investigate the suitability of a simple tool of assessment for patients with epistaxis that could guide in subgrouping those with possible bleeding tendencies who may need further assessment. Methods Children who presented to a tertiary outpatient clinic with epistaxis of an unknown cause were recruited. They underwent thorough clinical assessment and answered the pediatric bleeding questionnaire and the epistaxis severity score. All patients underwent complete blood count as well as coagulation profile, and confirmatory diagnostic tests were performed as needed. Results Among the 30,043 patients who presented to the outpatient clinic over a year, 100 children had epistaxis, with an estimated annual frequency of 1 in 300. A total of 84% of the patients were younger than 12, and nearly half of these were younger than 6 years. Seventy-six patients had recurrent epistaxis, and 12 had systemic comorbidities. A significant higher percentage of patients presented with epistaxis in the hot months of the year. A total of 90% of the patients presented anterior bleeding, and the majority were treated with nasal compression only. Forty-three patients presented with epistaxis only; 37 of them were diagnosed as idiopathic epistaxis, and 6 had local causes. Fifty-seven patients presented with other bleeding manifestations, 47 of whom had a definite bleeding disorder and the other 10 had undiagnosed bleeding tendency. Those with other bleeding manifestations showed a higher frequency of positive family history of epistaxis; of being referred from a primary care physician; of having alarming low platelet count, and of presenting less seasonal variability. A bleeding score ≥ 2 showed significant value in suspecting an underlying systemic pathology as a cause of epistaxis. Conclusion The pediatric bleeding questionnaire is a useful and simple tool in the identification of pediatric patients who need further diagnostic testing to detect any underlying bleeding tendency.

Analysis of risk factors in patients admitted with epistaxis

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Epistaxis can be classified into anterior and posterior epistaxis. All bleeding occurs as a result of disruption of the intact nasal mucosa, whether due to trauma, inflammation, or neoplasm. Management depends on the severity of the bleeding and its underlying cause.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; This study was done in department of otorhinolaryngology in a tertiary care centre from September 2018 to December 2020. A total of 143 patients were studies. All patients admitted in our department as a case of epistaxis were analysed for the risk factors present in them which could be the cause of epistaxis.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; In our study it was seen the risk factor involved in majority of patients was hypertension (70%), followed closely by diabetis mellitis and deranged coagulogram (65%). Chronic kidney disease was an associated risk factor in 64% of patients. All these factors cause microangiopathies which in turn lead to bleeding.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; The current study can be taken as indirect evidence that while raised blood pressure is seen in patients with severe epistaxis but in general the diseases associated with microangiopathies.&lt;/p&gt;

Ruptured infectious ICA pseudoaneurysm into the sphenoid sinus after maxillofacial infection, successfully treated by selective embolization

Background: Intracranial infectious aneurysms are cerebral aneurysms caused by pathogen-induced inflammation undermining the arterial wall. We present a rare case of inflammatory pseudoaneurysm of cavernous internal carotid artery (ICA).Case Description: A 51-year-old female with a recent diagnosis of acute lymphoblastic leukemia developed maxillofacial infection with Pseudomonas and Acinetobacter after chemotherapy onset. Initial plain computed tomography (CT) revealed bony dehiscence of the left ICA canal, as well as bilateral protrusion of the vessel within the sphenoid sinus. Following infection spread into the left sphenoid sinus, she presented with episodes of intermittent epistaxis, without any profound vascular abnormalities on postcontrast CT. CT angiography that was performed 15 days later, due to refractory epistaxis, illustrated a large narrow necked irregular shape pseudoaneurysm of the left paraophthalmic ICA, extending into the ipsilateral sphenoid sinus. The aneurysm was completely occluded by selective embolization without parent or adjacent vessel sacrifice, documented on both intraoperative and follow-up angiogram, with no recurrence of epistaxis.Conclusion: Conclusively, ruptured internal carotid infectious aneurysms are rare but potentially fatal causes of epistaxis when extended into the sphenoid sinus. Selective coiling is feasible and can provide definitive treatment of these lesions.