Severe Epistaxis Caused by Ruptured Aneurysm of the Internal Carotid Artery

Abstract

F ATAL epis taxis caused b y r u p t u r e of an a n e u r y s m of the in te rna l ca ro t id art e ry in to the p a r a n a s a l sinuses is a ve ry rare and d r a m a t i c condi t ion. Because of i ts r a r i t y we have u n d e r t a k e n a review of the p rev ious ly pub l i shed cases, to which we a d d 1 of our own. T h e first well documen ted case of an a n e u r y s m of the in te rna l ca ro t id a r t e r y wi th severe epis taxis was r epo r t ed b y De lens TM in 1870. His pa t i en t , a y o u n g m a n who sust a i ned a p e n e t r a t i n g in ju ry of the eye, d ied as a resu l t of the r u p t u r e d a n e u r y s m and aut o p s y was per formed. D u r i n g the 9S yea r s fol lowing t h a t r e p o r t on ly 18 add i t i ona l p roven examples have been publ ished. T h e m a n whose f indings are summar i zed below is the ~0th p r o v e n case known to us, and on ly the 9 th in which an a u t o p s y h a d been per formed. As he i l lus t ra tes so well the natu ra l h i s to ry of this condi t ion , his clinical and a u t o p s y f indings are given in detai l .