Abstract: A retrospective analysis was made on 5 cases who had the traumatic carotid artery injury with massive epistaxis (from September 2007 to June 2011). All of them were finally diagnosed by digital substraction angiography (DSA). Among them, 2 cases of traumatic pesudoaneurysm from internal maxillary artery were embolized with polyvinyl alcohol particles and gelatin sponge. One case was carotid-cavernous fistula (CCF) with traumatic pesudoaneurysm located in the sphenoid sinus. This patient's internal carotid artery (ICA) and fistula was blocked with balloon, and then ICA was clipped proximal to the posterior communicating artery. One case with injuried ICA was treated with blocking by balloon. The pesudoaneurysm located in ICA cavernous segment of one case was embolized with coil and liquid glue. No recurrence was found after successful surgeries. Patients with massive epistaxis or recurrent epistaxis after craniofacial trauma should undergo CT angiography (CTA) or DSA examination so as to get proper diagnosis and treatment as early as possible.

Key words: Carotid artery injuries, Epistaxis, Embolization, therapeutic, Ligation, Angiography, digital subtraction

摘要： 回顾分析5 例头面部外伤后鼻出血的创伤性颈动脉损伤患者临床资料，均经全脑血管造影检查明确诊断。2 例颌内动脉分支损伤，以聚乙烯醇颗粒及明胶海绵栓塞；1 例颈内动脉海绵窦瘘并蝶窦腔内假性动脉瘤形成，球囊闭塞瘘口和颈内动脉，再于后交通动脉近心端手术夹闭颈内动脉；1 例颈内动脉自床突段闭塞，采用球囊闭塞颈内动脉主干；1 例颈内动脉海绵窦末段假性动脉瘤，采用弹簧圈结合液态胶栓塞。术后无一例鼻出血复发。头面部外伤后鼻出血严重或反复鼻出血者，应行CT 血管造影或全脑血管造影检查，及时明确诊断，尽早治疗。

关键词: 颈动脉损伤, 鼻出血, 栓塞, 治疗性, 结扎术, 血管造影术, 数字减影