Ruptured middle cerebral artery aneurysm in an infant presenting as acute subdural hematoma: a case report.
ABSTRACT We present an unusual case of ruptured infantile cerebral aneurysm. An eight-month-old infant was delivered to the hospital in poor condition, after convulsions, with no history of trauma. His emergent CT study revealed acute subdural hematoma. The clinical and radiological picture evoked suspicion that the hematoma was of aneurysmal origin. The infant was operated with special preparations and precautions appropriate for aneurysmal surgery, and has shown a good recovery. It is important to consider the possibility of vascular accident in infants with subdural hematoma of nontraumatic origin. A good outcome may be achieved when appropriate preparations are made prior to surgery.
Article: Intracranial aneurysms of childhood.[show abstract] [hide abstract]
ABSTRACT: 15 cases of cerebral aneurysms in children between 8 and 15 years of age, all operated upon in a 20-year span (1956--1976), are reported. 7 of them were the carriers of large aneurysms (3 'giant'). Surgical mortality was limited to 2 patients with aneurysms of the middle cerebral artery and large intracerebral hematomas. All other patients are in satisfactory conditions, with a follow-up ranging from 2 to 22 years. A direct approach to the aneurysm was used in all but 3 cases. Certain features of cerebral aneurysms in children are discussed pertinently to this series.Child's brain 02/1980; 6(6):295-302.
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ABSTRACT: Longer life expectancies and differences in the underlying disease in children with aneurysms raise important issues concerning the choice of microsurgical or endovascular therapy. The authors reviewed their experience at one institution regarding patients treated between 1977 and 2003, focusing on the issue of treatment durability. Forty-three aneurysms in 32 pediatric patients were identified. The patients ranged in age from 2 months to 18 years (mean 11.7 years). Only seven patients (22%) presented with subarachnoid hemorrhage, and in nine patients (28%) significant medical comorbidities were present. Aneurysm locations included the internal carotid artery (13 lesions), middle cerebral artery (11 lesions), and the basilar artery/vertebrobasilar junction (six lesions). Of the 43 lesions, 17 (40%) were giant aneurysms and 22 (51%) exhibited fusiform/dolichoectatic morphological features. Thirteen patients underwent microsurgery, 16 endovascular treatment, and three observation. Complete aneurysm obliteration rates were 94 and 82% in the microsurgical and endovascular groups, respectively. There were no deaths in either group, and neurological morbidity rates were comparable. Over time, 14% of endovascularly treated aneurysms recurred, and in 19% of these patients de novo aneurysms developed (mean follow-up duration 5.7 years). In contrast, there were no recurrences in the microsurgically treated aneurysms and only one de novo aneurysm (6%). Both microsurgical and endovascular therapies can be conducted safely to treat pediatric aneurysms. Microsurgery may be more efficacious in completely eliminating the aneurysm and its effects more durable over the extended lifetime of these patients. Parental biases toward nonoperative therapy should be thoroughly addressed before ultimately selecting a treatment strategy.Journal of Neurosurgery 03/2006; 104(2 Suppl):82-9. · 3.15 Impact Factor
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ABSTRACT: Primary subarachnoid hemorrhage is rare in infancy. A bleeding arterial aneurysm as its cause is even less frequent. A review of the literature turned up 85 cases of cerebral aneurysm that occurred in the 1st year of life, 63 of them presenting with subarachnoid hemorrhage (SAH). The authors report a case of an 8-month-old boy who presented with seizures due to ruptured anterior communicating (ACom) artery aneurysm with subsequent subarachnoid and intraventricular hemorrhage. The infant was operated successfully, without complications. In this report the authors highlight certain clinical and diagnostic features, surgical considerations, and outcomes of aneurysmal subarachnoid hemorrhage in the 1st year of life.Child s Nervous System 08/2004; 20(7):489-93. · 1.24 Impact Factor