Determination of the specific site of bleeding can be achieved radiologically.
By placing a catheter from the femoral artery through the aorta and into the carotid circulation the sphenopalatine artery can be easily cannulated from the maxillary branch of the external carotid artery. Bleeding can usually be demonstrated and the vessel can be embolized using small particles.
Fortunately in this young boy’s case, bleeding stopped after further medical management and he remained asymptomatic.