Middle Ethmoid Artery Epistaxis: A Case of Post-Traumatic Severe Bleeding

Post-traumatic epistaxis is a common sequela of head trauma, typically arising from injury to the nasal mucosa or disruption of vascular structures, including the anterior-posterior ethmoid and sphenopalatine arteries. The ethmoid arterial system exhibits considerable anatomical variation, with middle ethmoid arteries identified in approximately 30-36% of cases. This report presents a rare instance of post-traumatic epistaxis originating from the middle ethmoid arteries in a pediatric patient with congenital thrombocytopenia, confirmed through computed tomography imaging and intraoperative assessment. The case emphasizes diagnostic and therapeutic challenges, highlighting the role of endoscopic surgical intervention in achieving hemostasis. Understanding the anatomical complexity of the ethmoid arterial system is crucial for accurate diagnosis and optimal management in similar cases.