Immediate post-traumatic pseudoaneurysm of the external carotid artery following condylar fracture: case report

INTRODUCTION: Pseudoaneurysms following mandibular condylar fractures are extremely rare and usually present weeks after trauma. Acute life-threatening presentations are exceptional. MATERIALS AND METHODS: A 19-year-old man was admitted in hemorrhagic shock after high-energy facial trauma. Imaging revealed bilateral comminuted condylar fractures associated with an actively bleeding pseudoaneurysm of the distal external carotid artery. Emergency endovascular coil embolization achieved rapid hemorrhage control, followed by surgical fixation of the mandibular symphysis. Postoperatively, the patient developed right peripheral facial paralysis, which partially recovered with conservative management. At six weeks, maximum mouth opening had improved to 20 mm and dental occlusion was stable. CONCLUSION: This case emphasizes the need to consider vascular injury in acute condylar trauma. Prompt vascular imaging and endovascular embolization are essential and potentially lifesaving.