Nontraumatic Internal Carotid Aneurysms in the Paranasal Sinuses Presenting with Epistaxis: A Case Report

Epistaxis due to rupture of a nontraumatic internal carotid artery (ICA) aneurysm in the paranasal sinus has rarely been reported. Here, we report a case of double ICA aneurysms located within both the sphenoid and ethmoid sinuses. A 78-year-old woman presented with recurrent massive epistaxis. Magnetic resonance angiogram (MRA) and cerebral angiogram showed two ICA aneurysms: one protruded into the sphenoid sinus and the other protruded into the ethmoid sinus. Intra-aneurysmal coil embolization was performed for both aneurysms. The patient recovered completely, and a follow-up MRA 3 years later showed no recurrence of the aneurysms. Intra-aneurysmal coil embolization is an option of treatment for an ICA aneurysm filling the paranasal sinus.