Massive posterior epistaxis. A manifestation of internal carotid injury at the skull base.

Severe crushing head injuries can produce massive posterior epistaxis as a result of injury to the internal carotid artery at the skull base. We describe two such cases with traumatic pseudoaneurysm of the internal carotid therapy. They were managed with detachable balloon embolization. The anatomy of the internal carotid artery is reviewed. The diagnosis of pseudoaneurysms and their incidence, clinical presentation, and management are discussed.