• Chang-Young Lee, Man-Bin Yim, and Goetz Benndorf.
• Department of Neurosurgery, Keimyung University School of Medicine, Daegu 700-712, South Korea. nslcy@dsmc.or.kr
• Surg Neurol. 2006 Oct 1; 66 (4): 444-6; discussion 446.

BackgroundTraumatic aneurysms of the internal maxillary artery are extremely rare. We report a case of traumatic pseudoaneurysm of the pharyngeal artery, a branch of the internal maxillary artery, presenting with hematemesis and hematochezia.Case DescriptionAn 18-year-old man presented with deep drowsy consciousness after a motor vehicle accident, in which he had a severe craniofacial injury. Three days later, he had hematemesis and hematochezia with a marked decrease in circulating hemoglobin level. External carotid arteriography performed to rule out vascular injury revealed active leakage from a false aneurysm of the pharyngeal artery. The lesion was successfully obliterated by superselective endovascular embolization.ConclusionsIn patients with craniofacial injury associated with multiple traumas, traumatic pseudoaneurysm of the pharyngeal artery should be suspected as one of the possible causes of hematemesis and hematochezia. Selective endovascular embolization with cerebral angiography is an effective modality for the treatment and diagnosis of this lesion.

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