Ruptured middle cerebral artery aneurysm in an infant presenting as acute subdural hematoma: A case report
Department of Neurosurgery, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.Pediatric Neurosurgery (Impact Factor: 0.33). 02/2008; 44(5):397-401. DOI: 10.1159/000149908
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.
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- "An. 11%--26%) 38% authors) in children; then the next location is anterior communicating artery (A. com); then MCA and M2 with ICH in up to 40% (three times more than other vessels) (mainly in neonates and infants). "
ABSTRACT: Pediatric aneurysms are different from adult aneurysms - they are more rare, are giant and in the posterior circulation more frequently than in adults and may be associated with congenital disorders. Infectious and traumatic aneursyms are also seen more frequently. Vein of Galen malformations are even rarer entities. They may be of choroidal or mural type. Based on the degree of AV shunting they may present with failure to thrive, with hydrocephalus or in severe cases with heart failure. The only possible treatment is by endovascular techniques - both transarterial and transvenous routes are employed. Rarely transtorcular approach is needed. These cases should be managed by an experienced neurointerventionist.
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