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Severe Epistaxis from a False Aneurysm of the External Carotid Artery

Carotid artery injuries resulting from blunt trauma are uncommon.' When cervical carotid artery injuries do occur, they are most often the result of penetrating trauma.' Intimal tears and adventitial contusions of the common carotid artery (CCA) are the most frequent findings in blunt arterial injuries ." The diagnosis of carotid artery injuries that result from blunt trauma may be overlooked or delayed because resultant neurologic symptoms frequently resemble those of closed head trauma. Four-vessel multiplane arteriography has been advocated as an adjunct to physical examination in all patients who have evidence of significant neck injuries that do not require immediate surgical intervention ." In this paper, we report what we believe to be the first case of external carotid artery (ECA) false aneurysm initially diagnosed as delayed and severe epistaxis. The management of this patient and the sequence of events that led to the diagnosis are presented .