Cavernous carotid aneurysm presenting with epistaxis

Background. Carotid artery aneurysms are a rare cause of epistaxis. The most common presentation for non-traumatic cavernous internal carotid artery aneurysms is mass effect, with only 3% presenting with hemorrhage, We present a case of epistaxis caused by a nontraumatic cavernous internal carotid artery aneurysm. Methods. A 73-year-old white woman was seen with a 1-month history of recurrent right-sided epistaxis. The patient had essential hypertension and a family history of intracranial aneurysm, A complete otolaryngologic, neurologic, and ophthalmologic examinations were normal, Contrast-enhanced CT of the paranasal sinuses revealed a trilobed aneurysm of the cavernous segment of the right internal carotid artery. Coil embolization of the cavernous aneurysm and right internal artery was performed. Results. The patient has had no further episodes of epistaxis and has remained neurologically intact. Conclusion. Carotid artery aneurysms must be considered in the differential diagnosis of profuse epistaxis.