Massive Epistaxis due to Traumatic Intracavernous Carotid Aneurys associated with Carotid-cavernous Fistula

A case of massive epistaxis due to a traumatic aneurysm of the internal carotid artery associated with an asymptomatic carotid-cavernous fistula is reported. Because of early opacification and engorgement of the cavernous sinus caused by the fistula, the traumatic aneurysm was overlooked and treatment was delayed. The lesions were treated by embolization of the fistula using a detachable balloon catheter and trapping of the internal carotid artery. The association of traumatic aneurysm and carotid-cavernous fistula is discussed and the relevant literature is reviewed.