Cerebral aneurysms in pediatrics: a case report and review of the literature

Abstract

Background: Cerebral aneurysms in pediatrics represent < 4% of the total of this condition, and their rupture represents 10-23% mortality. Aneurysms have been associated with infections, head injuries, sickle cell anemia, cardiovascular diseases, autoimmune diseases, immunodeficiencies, and connective tissue diseases. Their clinical presentation includes severe headache, seizures, motor-sensory deficits, and death due to subarachnoid and intraparenchymal hemorrhage. Case report: We describe the case of a 12-year-old female patient who presented with a sudden intense headache; after 72 hours, generalized tonic-clonic seizures were observed. At the hospital, she was stabilized with antiepileptic drugs and analgesics. A simple head computed tomography scan showed intraparenchymal hemorrhage in the right frontal lobe and subarachnoid hemorrhage. The study was complemented with a cerebral angiotomography, which revealed an aneurysm of the anterior communicating artery. The pediatric neurosurgeon evaluated the case, and management in the pediatric intensive care unit was decided. Two weeks after the stroke, the aneurysm was clipped and excluded. The patient developed adequate clinical evolution and resolution of initial symptoms, resuming her daily activities. Conclusions: Pediatric cerebral aneurysms differ from their adult counterparts, mainly in their etiology and evolution. In addition, pediatric patients have a longer life expectancy. Aneurysm clipping and neurological endovascular therapy have shown similar results.

Clinical efficacy of early microsurgical clipping of tumor neck in the treatment of cerebral aneurysm rupture and bleeding and its impact on oxidative stress response and prognosis of patients

“…CA rupture bleeding, as a common critical and severe condition in clinical neurosurgery, has a rapid onset and development, and is more common in middle-aged females [13]. The onset of CA rupture is due to damage and aging of patients' arterial wall caused by congenital weakness of cerebral artery, brain injury, or arteriosclerosis, leading to local vascular proliferation and formation of a cystic tumor; nevertheless, when the tumor is not ruptured, patients basically have no obvious symptoms [14,15]. If patients experience abnormal emotional excitement or excessive physical exertion, the tumor may receive stimulation by the body's stress response, leading to rupture and bleeding.…”

Pediatric Interventional Neuroradiology: Opportunities and Challenges

“…The discovery of intracranial aneurysms in children is rare and mostly incidental [ 43 ]. The pathogenesis is commonly related to underlying genetic abnormalities and developmental vascular tissue defects since the majority of the risk factors associated with intracranial aneurysms in adults are non-existent [ 44 , 45 ]. Cerebral aneurysms in children are morphologically different from their saccular counterparts in adults, presenting mostly in fusiform shape, dissecting, giant in size, and de novo aneurysms [ 46 ].…”

Ruptured Intracranial Aneurysm in a 60-Day-Old Infant: An Extreme Case

“…In the pediatric population, they often pose distinct clinical and anatomical characteristics that require a tailored approach. Unlike adult aneurysms, which are more frequently associated with risk factors such as hypertension and atherosclerosis, pediatric aneurysms tend to occur due to an underlying predisposing disorder, such as traumatic brain injury, sickle cell anemia, cardiovascular diseases, autoimmune diseases, immunodeficiencies, connective tissue diseases, dysmorphic syndromes, and positive family history [ 3 ].…”