A case of head injury, followed in five days by severe epistaxis, is reported in which the combined ligation of the external carotid artery followed in sequence by :ration of the anterior ethmoidal artery n the initial surgical procedure controlled the hemorrhage and proved ´to be a life-saving measure.
It is our conjecture that the accidental contusion of the left occipital area against the, wall, has invloved the left anterior ethmoidal artery and by secondary infection and erosion precipitated the severe epistaxis five days later. Ligation of the anterior ethmoidal artery as the initial, surgical procedure in case severe epistaxis-following head injuries is the object lesson; deduced from the experience of the authors reporting these types of cases as well as in this particular case.
The nasal packs were. removed on the-operating table after the first surgical arterial interru ption (external carotid artery) Since the bleeding persisted the second mayor arterial branch supplying the nose (anterior ethmoidal artery) was interrupted following which the bleeding ceased immediately.
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