TITLE:
Severe Traumatic Brain Injury with Sphenopalatine Artery Ruptured: Case Report and Review of the Literature
AUTHORS:
Adil Belhachmi, Yao Christian Hugues Dokponou, Fernand Nathan Imoumby, Napoléon Imbunhe, Sofia El Akroud, Miloudi Gazzaz
KEYWORDS:
Traumatic Brain Injury, Sphenopalatine Artery, Endovascular
JOURNAL NAME:
Open Journal of Modern Neurosurgery,
Vol.11 No.3,
July
23,
2021
ABSTRACT: Emergency endovascular procedure for external carotid exclusion is required to save patients with life-threatening massive epistaxis from a ruptured sphenopalatine artery secondary to severe traumatic brain injury. We report a case of a 20-year-old pedestrian admitted with a severe traumatic brain injury (TBI) secondary to an automobile (a lorry) road accident at high velocity. He presented to the emergency room in a coma with a Glasgow coma scale of 6/15 and massive epistaxis. He underwent emergency stabilization by sedation and was intubated. Body CT-Scan shows fracture of the palatine and pterygoid plate and multiple fractures of the skull with intracranial right frontal lobe hematoma. CT-Angiography was done immediately and confirmed a rupture of the sphenopalatine artery. The patient died of massive epistaxis while waiting for the endovascular procedure. This is a rare clinical case that needs unusual emergency endovascular management. Arterial embolization in emergency settings should be thought in front of any patient with persistent post-traumatic nose bleeding and be carried out as soon as possible to save the patient’s life.