Aim and objective: A rare presentation of intractable massive recurrent epistaxis diagnosed and managed. Background: Traumatic intracranial pesudoaneurysm is a rare complication of blunt trauma. Intracranial internal carotid artery pseudoaneurysm may rupture leading to delayed onset, massive, recurrent epistaxis, which requires an emergency intervention. Case description: Here, we present a case of recurrent massive intractable epistaxis due to a sphenoidal prolapse of supraclinoid part of right internal carotid artery, presenting as a pseudoaneurysm, secondary to a post-traumatic fracture dehiscence of roof of sphenoid, diagnosed with the help of a computed tomography angiography. The patient was treated successfully with a primary endovascular coiling. Conclusion: Intractable epistaxis due to a post-traumatic pseudoaneurysm is quite rare and can be fatal and hence need to be considered in the differential diagnosis of massive recurrent uncontrollable epistaxis and treated at the earliest. Clinical significance: The reach of presentations of such rare cases should be broadened as these are difficult to be diagnosed and managed. Inadequate and untimely diagnosis and management of such cases can cost the life of the patients.
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