Giant Petrous Carotid Aneurysm: Persistent Epistaxis Despite Internal Carotid Artery Ligation

J Laryngol Otol. 2008 Aug;122(8):e18. doi: 10.1017/S002221510800282X. Epub 2008 Jun 13.


Objectives: We report a rare case of giant petrous carotid aneurysm.

Method: Case report and a review of the literature regarding treatment options for such aneurysms.

Results: A 30-year-old man presented with epistaxis, headaches and visual disturbance. Definitive diagnosis was achieved by non-invasive imaging techniques, including magnetic resonance angiography and carotid angiography. Carotid angiography demonstrated a giant petrous carotid aneurysm effacing the petrous apex. The aneurysm was obliterated by internal carotid artery ligation, following successful tolerance of the balloon occlusion test. However, despite internal carotid artery ligation, this patient continued to have minor episodes of epistaxis.

Conclusion: Some aneurysms are too large to be treated with endovascular occlusion techniques; in such cases, ligation of the parent vessel is indicated. However, our patient continued to experience persistent, mild epistaxis despite internal carotid artery ligation, as a result of the reperfusion phenomenon.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Carotid Artery Diseases / complications*
  • Carotid Artery Diseases / diagnosis
  • Carotid Artery Diseases / surgery
  • Carotid Artery, Internal / diagnostic imaging
  • Carotid Artery, Internal / surgery
  • Cerebral Angiography
  • Epistaxis / diagnosis
  • Epistaxis / etiology*
  • Epistaxis / surgery
  • Humans
  • Intracranial Aneurysm / complications*
  • Intracranial Aneurysm / diagnosis
  • Intracranial Aneurysm / surgery
  • Ligation
  • Magnetic Resonance Angiography
  • Male