Abstract
We report a rare case of traumatic cavernous sinus aneurysm, treated with internal carotid artery trapping and superficial temporal artery-middle cerebral artery double anastomoses.
A 23-year-old man was admitted with disturbance of consciousness and epistaxis after a bicycle accident. On the first admission, the patient was noted to be confused. A fracture of the frontal base of the skull and an acute epidural hematoma of the left temporal lobe were diagnosed, treated conservatively for 2 weeks.
On the day after discharge, the patient was readmitted owing to severe epistaxis. Angiography revealed a left cavernous sinus (internal carotid artery) aneurysm that had been caused by original accident. The patient was treated with internal carotid artery trapping of the anterior part of the opthalmic artery and superficial temporal artery-middle cerebral artery double anastomoses. After the operation, the patient was discharged with a residual left visual field defect.
Unlike most reported cases, this case was manifested only by epistaxis and not by other symptoms, such as optic nerve palsy.
