Central Retinal and Posterior Ciliary Artery Occlusion After Particle Embolization of the External Carotid Artery System

A 15-year-old boy was struck with a baseball over the nasal bridge. After two days of epistaxis from his left nares, he was admitted to a local hospital. Tomograms revealed a comminuted nasal fracture. The nose was packed with polyvinyl alcohol and intravenous antibiotics were administered. Twelve hours after admission, nasal arterial bleeding increased. Nasal packings were replaced, but did not control the epistaxis. The hematocrit fell from 37% on admission to 29% four days later. Surgical ligation of the left anterior and posterior ethmoidal arteries, and a submucous resection of the nasal septum were performed. However, epistaxis continued. He was transfused with two units of packed red blood cells.