Summary
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1.
Four cases of traumatic aneurysm of the internal carotid artery are presented and the available literature is reviewed. In 3 cases, a massive epistaxis occurred following rupture of the aneurysm into the paranasal sinuses. In the remaining case, no epistaxis occurred, but the caroticocavernous fistula was associated with the aneurysm and both were studied by repeated angiograms over several months.
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2.
Fracture of the base of the skull, monocular blindness and recurrent severe epistaxis of late onset strongly suggest that a traumatic aneurysm of the internal carotid artery at the base of the skull is present.
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3.
Surgical treatment has been briefly discussed.
Zusammenfassung
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1.
Bericht über 4 Fälle mit traumatischen Aneurysmen der A. carotis interna und Übersicht über die zugehörige Literatur. Bei 3 Fällen war es zu massiven Blutungen in den Nasen-Rachen-Baum gekommen, bedingt durch eine Ruptur der Aneurysmen in die Nasennebenhöhlen. Bei dem 4. Fall, bei dem keine Blutung in den Nasen-Rachen-Raum entstand, war gleichzeitig eine Kurzschlußverbindung zwischen Karotis und Sinus cavernosus entstanden.
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2.
Schädelbasisfraktur, einseitige Blindheit und rezidivierende schwere Blutungen in den Nasen-Rachen-Raum einige Zeit nach dem Trauma müssen immer an ein traumatisches Aneurysma der A. carotis interna im Bereiche der Schädelbasis denken lassen.
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3.
Die Möglichkeiten chirurgischer Therapie wurden kurz diskutiert.
Résumé
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1.
4 cas d'anévrysmes traumatiques de l'artère carotide interne sont rapportés. Chez 3 malades, rupture de l'anévrysme dans les sinus paranasaux avec saignement du nez extrêmement sévère. Pas dépistaxis dans la quatrième cas, mais formation d'dune fistule entre l'artère carotide interne et le sinus caverneux, suivie par l'angiographie pendant plusieurs mois. Discussion de la littérature.
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2.
Les symptômes d'un anevrysme traumatique de l'artère carotide interne sont les suivants: fracture de la base du crâne, amaurose unilatérale, sévère épistaxis tardif et récidivant.
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3.
Discussion brève du traitement chirurgical.
Riassunto
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1.
Vengono esposti 4 casi di aneurismi traumatici della carotide interna e si passa in rassegna la letteratura esistente sull'argomento.
In 3 casi si ebbe un'epistassi massiccia come fenomeno secondario alla rottura dell'aneurisma nel seno paranasale. Nel quarto caso, non vi fu epistassi, ma la fistola del seno cavernoso carotideo era collegata con l'aneurisma, ed entrambi furono tenuti sotto controllo per vari mesi con ripetuti esami angiografici.
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2.
La frattura della base cranica, con cecità monoculare e per ultimo una grave epistassi ricorrente indicarono chiaramente la presenza di un aneurisma traumatico della carotide interna alla base del cranio.
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3.
Viene discusso brevemente il trattamento chirurgico.
Resumen
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1.
Se presentan cuatro casos de aneurismas traumáticos de la carótida interna y se revisa toda la literatura sobre estos procesos. En 3 casos se presentó una epistaxis masiva secundaria a la ruptura del aneurisma dentro de los senos paranasales. En el caso restante no se presentó epistaxis pero una fístula carótido-cavernosa se asoció al aneurisma y ambos pudieron ser seguidos con arteriografías durante varios meses.
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2.
La fractura de la base del craneo, la ceguera de un ojo y las epistaxis grandes y repetidas, de aparición tardía, indican la existencia de un aneurisma traumático de la arteria carótida interna en la base del craneo.
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3.
Se discuten brevemente los tratamientos quirúrgicos.
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Handa, J., Kikuchi, H., Iwayama, K. et al. Traumatic aneurysm of the internal carotid artery. Acta neurochir 17, 161–177 (1968). https://doi.org/10.1007/BF01402536
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DOI: https://doi.org/10.1007/BF01402536