Internal Carotid Artery Aneurysm

A 51 year-old female patient presented with headache. This coronal reformat of a CT cerebral angiogram shows a right internal carotid artery aneurysm arising from the clinoid or proximal ophthalmic segment (probably at the origin of the ophthalmic artery). The aneurysm erodes the sphenoid bone and protrudes into the sphenoid sinus - a graphic demonstration of the potential for epistaxis, a rare presentation of cerebral aneurysm.
The most common presentation of cavernous ICA aneurysms is with mass effect, with only 3% presenting with epistaxis. Coil embolisation is a treatment option for cavernous ICA aneurysms presenting with epistaxis.
Reference: Chaboki H, et al. Cavernous carotid aneurysm presenting with epistaxis. Head & Neck 2004, 26(8), 741-746
Credit: Dr Laughlin Dawes
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