A Subarachnoid Hemorrhage Presenting as Massive Nasopharyngeal Bleeding: A Case Report. Issue 1 (1st July 2018)

• Record Type: Journal Article
• Authors: Zvara, Jessica; Hafen, Ryan D.; Angelotti, Timothy
• Is Part Of: A & A practice. Volume 11:Issue 1(2018)
• Publication Date: 2018-07-01
• Subjects: Analgesia -- Periodicals; Analgesia -- Case studies -- Periodicals; Anesthesiology -- Periodicals; Anesthesiology -- Case studies -- Periodicals; 617.9605
• DOI: 10.1213/XAA.0000000000000720
• Languages: English
• ISSNs: 2575-3126

Abstract

Abstract : Patients who present with a subarachnoid hemorrhage may have more than 1 intracranial aneurysm at risk, which may not be appreciated until a subsequent aneurysmal bleeding event occurs. We describe a patient who underwent successful aneurysmal clipping, but later presented urgently with large-volume epistaxis 48 hours after the procedure. After successful intubation of the patient, subsequent angiographic imaging determined that the massive intranasal/oral hemorrhage was due to bleeding through the former operative site, from rupture of a previously unrecognized aneurysm. This series of events demonstrates the importance of selecting the most at-risk aneurysm for surgical intervention.