Neurological Sciences

, Volume 40, Issue 1, pp 203–205 | Cite as

Epistaxis as unusual presentation of carotid siphon aneurysms, evolved in subacute carotid thrombosis

  • Laura Strada
  • Ivan Bonanni
  • Nicola Mavilio
  • Antonio Castaldi
  • Massimo Del Sette
Letter to the Editor


Epistaxis as the first clinical manifestation of intracranial aneurysm is a rare event. Moreover, coexistence of aneurysm rupture and progressing stroke due to spontaneous aneurysm thrombosis generates a complex decision-making discussion.

Case presentation

An 88-year-old man with history of mild hypertension since age 65 and two remote transient ischemic attacks at age 66 and 72, in treatment with Clopidogrel, presented to the emergency department for a severe epistaxis with acute onset.

He had experienced right facial pain for the previous month and had a neurological evaluation two weeks prior to the episode of epistaxis that had not found any neurological abnormality. However, during the neurological evaluation, he had an initial episode of epistaxis, which was treated with nasal packing.

Epistaxis continued for at least 3 h, requiring anterior and posterior nasal packing and two blood transfusions of concentrated red blood cells. Rhinoscopy showed only blood clots in...


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Copyright information

© Springer-Verlag Italia S.r.l., part of Springer Nature 2018

Authors and Affiliations

  1. 1.Neurology UnitE.O. Ospedali GallieraGenoaItaly
  2. 2.Policlinico San MartinoGenoaItaly
  3. 3.Neuroradiology UnitE.O. Ospedali GallieraGenoaItaly

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