Epistaxis is a frequent complication after head trauma. More often it is caused by mucosal laceration or lesion of a branch of the anterior etmoid or sphenopalatine artery. In some rare cases, the hemorrhage may be due to a trauma of the internal carotid artery, in the form of an aneurysm or pseudoaneurysm, or even a carotid-cavernous fistula. In this cases the bleeding is often massive, requiring quick diagnosis and therapeutical measures. We present a case of a young man who developed massive nasal bleeding after a head trauma, due to the rupture of a pseudoaneurysm of the intracavernous internal carotid artery. He was treated with angiographic embolization and despite the control of the epistaxis, he presented a large cerebral ischemia. The epistaxis that follows the rupture of an aneurysm or pseudoaneurysm is massive, and often lethal. Therefore, we must always have this diagnosis in mind, to allow a quick intervention and control of the hemorrage.