Ruptured Infectious Internal Carotid Artery Aneurysm Presenting with Epistaxis: A Case Report

ABSTRACT

Cavernous carotid aneurysms represent fewer than 2% of all intracranial aneurysms and are a rare cause of epistaxis, but rupture of an aneurysm into the sphenoid sinus may result in a massive hemorrhage. Infectious intracranial aneurysms are rare, but can develop as a result of direct extension from bacterial endocarditis or local infection of the head, neck, face, and paranasal sinus. The incidence of infectious intracavernous aneurysm is much lower. Because the sphenoid sinus is located adjacent to the cavernous sinus, sphenoid sinusitis may cause an infectious carotid aneurysm. We have experienced a case of ruptured infectious carotid aneurysm following sphenoid sinusitis presenting with epistaxis. We describe several aspects of the diagnosis and management of this rare case with a review of the literature.