Reconstructive endovascular treatment of petrous ICA pseudoaneurysm in skull base osteomyelitis: a hidden catastrophe

BMJ Case Rep. 2024 Feb 27;17(2):e258539. doi: 10.1136/bcr-2023-258539.

Abstract

Skull base osteomyelitis can be more life-threatening in immunocompromised patients and patients with diabetes. Here, we present a case of a petrous internal carotid artery pseudoaneurysm resulting from skull base osteomyelitis in a diabetic male in his 50s. This case report highlights the need to be conscious of the various complications associated with skull base osteomyelitis, be proficient in detecting them and treat them as early as possible for better outcomes. After adequate control of the disease process with medical treatment, immediate management of the aneurysm with balloon angioplasty and stenting was done. Acknowledging the trivial nasal and ear bleed, radiological evaluation is necessary to rule out rare complications like pseudoaneurysms in a diagnosed case of skull base osteomyelitis. In the discussion, we have cited the various treatment methods and similar cases of pseudoaneurysm caused by osteomyelitis. Currently, the patient continues to live a disease and disability-free life.

Keywords: Ear, nose and throat; Interventional radiology.

Publication types

  • Case Reports

MeSH terms

  • Aneurysm* / complications
  • Aneurysm, False* / diagnostic imaging
  • Aneurysm, False* / etiology
  • Aneurysm, False* / therapy
  • Carotid Artery, Internal / surgery
  • Humans
  • Male
  • Osteomyelitis* / complications
  • Osteomyelitis* / diagnostic imaging
  • Osteomyelitis* / therapy
  • Radiography
  • Skull Base / diagnostic imaging
  • Skull Base / surgery