Akil P Patel1, Dheeraj Gandhi2, Rodney J Taylor3, Graeme Woodworth4. 1. Department of Neurosurgery, University of Maryland, Medical Center, Baltimore, Maryland, USA. 2. Department of Neuro-Interventional Radiology, University of Maryland, Medical Center, Baltimore, Maryland, USA. 3. Department of Otolaryngology, University of Maryland, Medical Center, Baltimore, Maryland, USA. 4. Department of Neurological Surgery, University of Maryland, School of Medicine, Baltimore, Maryland, USA.
Abstract
BACKGROUND: Digital subtraction angiography (DSA) is considered the gold standard for the evaluation of head and neck vascular abnormalities. It serves as a useful diagnostic and, in many cases, therapeutic tool for treatment of acute head and neck bleeding. CASE DESCRIPTION: We report the case of a patient who presented with life threatening, uncontrollable epistaxis several weeks after resection of a large recurrent chondrosarcoma of the nasal cavity and anterior skull base. A DSA study, with an adjunctive C-arm computed tomography (CT) (Dyna CT), was ultimately helpful in revealing and precisely localizing a large anterior ethmoidal artery pseudoaneurysm adjacent to the tumor resection cavity. CONCLUSION: This additional information helped define the arterial anatomy in postoperative region, allowed precise localization and direct ligation of the pseudoaneurysm to resolve the bleeding with a favorable patient outcome.
BACKGROUND: Digital subtraction angiography (DSA) is considered the gold standard for the evaluation of head and neck vascular abnormalities. It serves as a useful diagnostic and, in many cases, therapeutic tool for treatment of acute head and neck bleeding. CASE DESCRIPTION: We report the case of a patient who presented with life threatening, uncontrollable epistaxis several weeks after resection of a large recurrent chondrosarcoma of the nasal cavity and anterior skull base. A DSA study, with an adjunctive C-arm computed tomography (CT) (Dyna CT), was ultimately helpful in revealing and precisely localizing a large anterior ethmoidal artery pseudoaneurysm adjacent to the tumor resection cavity. CONCLUSION: This additional information helped define the arterial anatomy in postoperative region, allowed precise localization and direct ligation of the pseudoaneurysm to resolve the bleeding with a favorable patient outcome.
Authors: T Hiu; N Kitagawa; M Morikawa; K Hayashi; N Horie; Y Morofuji; K Suyama; I Nagata Journal: AJNR Am J Neuroradiol Date: 2009-02-12 Impact factor: 3.825
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