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July 1959

Ruptured Intracranial Carotid Artery Aneurysm with Fatal Epistaxis

Author Affiliations

New York
From the Otolaryngology Section of the Surgical Service and the Laboratory Service, Veterans Administration Hospital and Albert Einstein College of Medicine.

AMA Arch Otolaryngol. 1959;70(1):52-60. doi:10.1001/archotol.1959.00730040056009

Intracranial aneurysms are primarily a neurosurgical problem. The patient with an intracranial aneurysm may be seen initially, however, by the ophthalmologist or the otolaryngologist. It is the purpose of this paper to review the subject of traumatic internal carotid artery aneurysm, show how epistaxis may be a conspicuous part of the clinical features, and present an illustrative case.

Anatomy  In order to comprehend fully the symptoms produced by the intracranial aneurysm, a brief review of the intracranial course of the internal carotid artery is indicated.As the internal carotid artery ascends into the carotid canal, it lies anteroinferior to the tympanum and cochlea, posteromedial to the Eustachian tube and the canal for the tensor tympani muscle (Fig. 1). Only a very thin lamella of bone separates the artery in its canal from the Eustachian tube and tympanum (Fig. 2) and this lamella frequently is found to be perforated. As the

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