The incidence of intracranial aneurysms in the pediatric population is low, and surgical clipping remains a good long-term treatment option. However, posterior circulation aneurysms are even more complex to manage in children than in adults. We report a case of a giant aneurysm of the posterior cerebral artery in a 10-year-old boy presenting with subarachnoid hemorrhage. Endovascular treatment with platinum coils was performed with total occlusion of the aneurysm and the affected arterial segment without complications. The patient achieved good recovery, and a late control angiogram confirmed exclusion of the aneurysm. Occurrence of special features of cerebral aneurysm in children, in comparison to adults, is also described. Parent artery sacrifice is an effective therapeutic option, but long-term follow-up is necessary to avoid recurrence and rebleeding.

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RESUMO -Avaliamos por angiografia pela ressonância magnética e por angiografia cerebral 41 pacientes com 55 aneurismas intracranianos confirmados pela cirurgia. A angiorressonância detectou 52 aneurismas com sensibilidade de 94,5% e a angiografia cerebral detectou 53 aneurismas com sensibilidade de 96,3%. Pela não invasibilidade, rapidez e baixo custo a angiorressonância poderá substituir a angiografia cerebral no diagnóstico de aneurismas intracranianos e no prognóstico da hemorragia subaracnóide. PALAVRAS-CHAVE: aneurismas intracranianos, angiografia pela ressonância magnética, angiografia cerebral, hemorragia subaracnóide. Magnetic resonance angiography of intracranial aneurysms: comparison study with cerebral angiographyABSTRACT -We studied by magnetic resonance angiography and cerebral angiography 41 patients with 55 aneurysms confirmed by surgery. The MR angio detected 52 aneurysms with sensibility of 94.5% and the cerebral angiography detected 53 aneurysms with sensibility of 96.3%. For being non invasive, more quickly and less expensive MR angio may substitute vascular angiography in the diagnosis of intracranial aneurysms and prognosis of the subaracachnoid hemorrhage KEY WORDS: intracranial aneurysms, magnetic resonace angiography, cerebral angiography, subarachnoid hemorrhage. Estudos de autópsia estimam a incidência de aneurismas intracranianos entre 1,3% e 7,9% 1.2 . Acredita-se que 8% da população possuam aneurismas intracranianos e que 20 000 aneurismas cerebrais se rompam por ano nos EUA. A ressonância magné-tica (RM) e a angiorressonância cerebral são consideradas exames de escolha para prevenção de indivíduos com suspeita de aneurismas intracranianos 3 . A análise de um grupo de 3081 indivíduos adultos com aneurismas únicos e hemorragia subaracnóide demonstrou a ocorrência de um pico em sua distribuição de frequências ao redor da quinta década de vida 4 . A incidência de hemorragia subaracnóide por aneurismas intracranianos é estimada em 10 por 100 000 habitantes/ano em várias séries na literatura [5][6][7] .A angiografia cerebral é ainda considerada "padrão ouro" para o diagnóstico em pacientes com hemorragia subaracnóide não traumática. Sua finalidade é identificar a presença de um ou mais aneurismas, delinear a relação entre um determinado aneurisma, seu vaso principal e ramos perfurantes adjacentes, definir o potencial de circulação colateral para o cérebro e avaliar a ocorrência de vasoespasmo.A angiorressonância cerebral (angioRM), utilizada para estudo das estruturas vasculares intra e extracranianas, baseia-se no método de imagem descrito em 1977 8 . São realizadas sequências de eco-gradiente, nas quais o sangue circulante é o contraste e, através do fluxo sanguíneo, são obtidos sinais que se transformam em imagens. A forma de reconstrução tridimensional espacial da angioRM subtrai a imagem do tecido estacionário, possibilitando a visibilização do território vascular.O diagnóstico exato do número, local, morfologia, relações topográficas e dimensões dos aneurismas são fundamentais para ...

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Carotid stenosis is the narrowing of the carotid arteries due to atherosclerosis. Our goal in this study was to search for copy number variants (CNV) in the human genome which may be related to risk of plaque formation and rupture. We obtained DNA from age matched patients at Hospital das Clínicas, in Campinas. Our cohort is composed by 15 patients with asymptomatic carotid stenosis and 15 with symptomatic carotid stenosis. All samples were genotyped using a SNP microarray and analysed. We identified various CNVs located in genes of the complement system, cytoskeletal remodelling and cell adhesion pathways. In our samples, we observed deletions in genes from both classical and lectin pathways of the complement system. Low levels of lectin binding mannose (MBL), is related to enhanced plaque formation. In addition, we found three patients with duplications in UPAR. The urokinase-type plasminogen activator receptor is part of the cytoskeletal remodelling pathway and has been previously associated to plaque rupture due to its increased expression in macrophages. Furthermore, we found a duplication in the PKC gene in one patient. It is known that Protein Kinase C, present at the cell adhesion pathway, when active stimulates the adhesion of monocytes to endothelial cells, therefore accelerating plaque formation. Overall, our results indicate that genes related to plaque formation and rupture were either duplicated or deleted in patients with asymptomatic carotid stenosis.

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C-terminal binding protein 2 (CTBP2) gene can be related with mechanisms involved in the pathogenesis of type II Focal cortical dysplasia (FCD). The main goal of this work is to investigate the frequency of a single nucelotide variant (SNV) identified in CTBP2, rs76555439, in a cohort of patients with FCD and compare it with healthy control individuals.