Massive Transoral Bleeding from the Internal Carotid Artery in a Patient With Granulomatosis With Polyangiitis (Wegener)

BACKGROUND: In the oral and maxillofacial area, granulomatosis with polyangiitis (GPA) can lead to extended tissue destruction.

CASE REPORT: This is a case report of a life-threatening local complication resulting from a large osseous defect in the cranial base with consecutive massive bleeding from the right internal carotid artery. Intraoperative examination and diagnostic imaging led to neuroradiological interventional treatment by embolization, and in neurosurgical and further reconstructive surgical treatment by the oral and maxillofacial surgeons. The purpose of this case report was to draw attention to the possibly life-threatening local complications of GPA and to discuss the importance of early intervention.

CONCLUSION: As a prevention strategy, regular examinations including three-dimensional radiographic diagnostic imaging are important for the early detection of complications and the possible involvement of important structures.