Internal carotid artery aneurysm presenting with severe epistaxis.

A case of aneurysm of the cavernous part of right Internal Carotid Artery is reported. This is a rare condition. The patient presented with recurrent episodes of epistaxis from right nostril for 10 years. Previously his right Common Carotid Artery and subsequently the Internal Carotid Artery had been ligated in the neck without benefit. A right frontal craniotomy had failed to reveal the aneurysm. Eventually his to the origin of right posterior communicating artery right Internal Carotid Artery was clipped proximal resulting in cure (JPMA: 37: 53 , 1987). Aneurysm of the petrous and cavernous parts of the Internal Carotid Artery is a rare qdndition, accounting for less than 1% of all intracranial aneurysms. Rupture into the paranasal sinuses leading to severe epistaxis, a potentially serious and occasionally fatal condition, is even less frequent. Delens was first to report on this condition in 1870 in a young man who died of rupture of an Internal Carotid Artery aneurysm following a penetrating injury to the eye. Beadles reported a case of epistaxis from a non-traumatic aneurysm of Internal Carotid Artery. The patient was a 61 year old woman who died from haemorrhage at St. Thomas’s Hospital, London, in 1889. Since then, 70 cases have been reported in world literature. Ninety percent of these cases had a history of trauma, either penetrating or non-penetrating. The history in most cases was short and the events dramatic. We present a patient with epistaxis from an Internal Carotid Artery aneurysm without a history of trauma and where the illness extended over a period of 10 years.