Internal Carotid Artery Pseudoaneurysm Secondary to Skull Base Osteomyelitis: A Case Report
0
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
We report a case of a pseudoaneurysm secondary to skull base osteomyelitis (SBO) in an 82-year-old female. The patient was hospitalized with an acute episode of bleeding from the right ear, which persisted despite packing placed in the ear. We suspected bleeding from the internal carotid artery (ICA) and performed angiography, which revealed a pseudoaneurysm that presumably developed secondary to invasion of the wall of the petrous segment of the right ICA, and the patient underwent emergency coil embolization. Bleeding from the ear recurred a week later, and we performed repeat angiography, followed by embolization and deployment of multiple stents at the site of the pseudoaneurysm, which controlled the bleeding. Clinicians should be mindful of a pseudoaneurysm as a rare complication of SBO, following the spread of infection to adjacent soft tissues or vessels. A pseudoaneurysm should be considered in the differential diagnosis in patients with recurrent epistaxis or bleeding from the ears in addition to cranial nerve symptoms, and this condition warrants urgent evaluation.
Abstract
We report a case of a pseudoaneurysm secondary to skull base osteomyelitis (SBO) in an 82-year-old female. The patient was hospitalized with an acute episode of bleeding from the right ear, which persisted despite packing placed in the ear. We suspected bleeding from the internal carotid artery (ICA) and performed angiography, which revealed a pseudoaneurysm that presumably developed secondary to invasion of the wall of the petrous segment of the right ICA, and the patient underwent emergency coil embolization. Bleeding from the ear recurred a week later, and we performed repeat angiography, followed by embolization and deployment of multiple stents at the site of the pseudoaneurysm, which controlled the bleeding. Clinicians should be mindful of a pseudoaneurysm as a rare complication of SBO, following the spread of infection to adjacent soft tissues or vessels. A pseudoaneurysm should be considered in the differential diagnosis in patients with recurrent epistaxis or bleeding from the ears in addition to cranial nerve symptoms, and this condition warrants urgent evaluation.
참고문헌 (9)
- Rothholtz VS, "Skull base osteomyelitis : the effect of comorbid disease on hospitalization", Laryngoscope, 118, pp.1917~1924 (2008)
- Mani N, "Cranial nerve involvement in malignant external otitis : implications for clinical outcome", Laryngoscope, 117, pp.907~910 (2007)
- Haider AS, "Mycotic pseudoaneurysm associated with skull base osteomyelitis treated with endovascular embolization", Cureus, 9, pp.e1622~ (2017)
- Hassannia F, "Internal carotid artery aneurysm in skull base osteomyelitis : does the pattern of cranial nerve involvement matter?", J Laryngol Otol, 132, pp.929~931 (2018)
- Kreicher KL, "Propionibacterium skull base osteomyelitis complicated by internal carotid artery pseudoaneurysm", Laryngoscope, 127, pp.2337~2339 (2017)
- Chen CN, "Outcomes of malignant external otitis : survival vs mortality", Acta Otolaryngol, 130, pp.89~94 (2010)
- Blyth CC, "Skullbase osteomyelitis : fungal vs. bacterial infection", Clin Microbiol Infect, 17, pp.306~311 (2011)
- Fankhauser GT, "Surgical and medical management of extracranial carotid artery aneurysms", J Vasc Surg, 61, pp.389~393 (2015)
- McGrail KM, "Aneurysm of the ICA petrous segment treated by balloon entrapment after EC-IC bypass", J Neurosurg, 65, pp.249~252 (1986)