Ruptured saccular cavernous carotid aneurysm presenting as a rare cause of epistaxis: a case report and comprehensive literature review

Epistaxis with an intracranial cause is typically attributed to either traumatic carotid cavernous fistula or mycotic aneurysm rupture secondary to sinusitis with skull base erosion. In rare cases, it is described following the rupture of an idiopathic saccular aneurysm originating in the cavernous segment of the carotid artery with protrusion into the paranasal sinuses. Here, we report the case of a 71-year-old patient who presented with multiple episodes of epistaxis secondary to a ruptured cavernous carotid aneurysm that extended to the left sphenoid sinus. The patient was treated by coil embolization, followed by occlusion of the left internal carotid artery because of recanalization.