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KMID : 1143720110070020108
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Korean Journal of Neurotrauma
2011 Volume.7 No. 2 p.108 ~ p.111
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Endovascular Treatment of Life-Threatening Bleeding of Bilateral Maxillary Arteries in a Patient with Multiple Facial Bone Fractures- A Case Report
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Kim Do-Yeon
Hyun Dong-Keun
Park Hyeon-Seon
Chung Joon-Ho
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Abstract
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Bleeding from bilateral internal maxillary artery (IMA) injury may result in a life-threatening situation and greater urgency for resuscitation. Here we report a case of life-threatening bleeding of bilateral maxillary arteries in multiple facial bone fractures, which was treated by endovascular treatment. A 77-year-old woman sustained a fall from five meters height. She was transferred to our institution with stuporous consciousness, active oronasal bleeding, multiple facial laceration, facial deformity and both forearm swelling. Selective angiography of bilateral external carotid arteries (ECA) demonstrated contrast extravasation in the distal branches of the right IMA and in the proximal segment of the left IMA involving the left middle meningeal artery. Endovascular embolization with polyvinyl alcohol (PVA) particle successfully stopped bleeding from the bilateral IMA. At one-year clinical follow-up, she recovered without any neurological deficit except some clumsiness of her both hands due to bilateral radioulnar fractures. In patients with life-threatening bleeding from bilateral IMA, endovascular embolization with PVA particle may be considered as a good treatment option.
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KEYWORD
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Endovascular treatment, Facial bone fractures, Maxillary artery injury, PVA particle
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