Saccular Aneurysm of Infancy and Early Childhood

Abstract

A case of intracranial saccular aneurysm occurring in early childhood and presenting with sudden dysphasia and hemiplegia is reported. A review of the literature emphasizes the rarity of this lesion. Despite a significant preoperative neurological deficit, the patient tolerated aneurysm clipping and recovered well. The majority of reported cases involve males under 2 years old. Aneurysms in infants have a distribution different from that seen in adults. Microscopic examination of these lesions fails to show any evidence of inflammation or atherosclerosis. The data suggest that the pathogenesis of these rare childhool lesions differs from that of adult saccular aneurysms.

An Intracranial Aneurysm and Dural Arteriovenous Fistula in a Newborn

“…The intraventricular bleed with hydrocephalus found at 2 weeks of age in our patient is retrospectively suspicious of rupture of the aneurysm, confirming that the presentation of subarachnoid hemorrhage and aneurysm in young infants is often mistaken for other more common diagnoses as is mentioned throughout the literature [56,58,60,62,64,73,77]. …”

“…In two case series describing aneurysms treated between 1991 and 2004, infants with ruptured aneurysms achieved a Glasgow Outcome Scale score of 5 in 63 and 62% of patients, respectively [67,72]. In general, it is believed that infants have a better outcome than the adult population [51,55,56,65,73,74,75,76]. This may be attributed to the lack of systemic hypertension and a lower incidence of vasospasm [57].…”

“…The incidence of pediatric intracerebral aneurysms is 0.17–4% of all cases [1,2,3,4,5,6]. Only 131 cases of cerebral aneurysms have been reported in infants younger than 12 months [3,5,7,8,9,10,11,12,13,14,15,16,17,18,19,20]. Likewise, there are very few case series reporting dural arteriovenous fistulae (DAVF) in this population.…”

Intracranial Aneurysms in the Pediatric Age-Group

“…There were 4 patients under the age o f 5 years [6]. There was a male to female distribution of 13:16.…”

Infantile Cerebral Aneurysms with Visual Pathway Compression

“…However, there are several reports of pediatric aneurysms with absent media and an intact internal elastic membrane, suggesting a congenital etiology [4, 26, 27]. It should be emphasized that though they are rare in early childhood, intracranial aneurysms do occur, and can cause visual loss and macrocephaly.…”