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Sudden death in an infant caused by rupture of a basilar artery aneurysm
1Regina Medical Center, Hastings, Minnesota 55033, USA.
Insights
Ruptured cerebral aneurysms are rare in infants and can cause sudden death. Morphologic findings may mimic inflicted trauma, highlighting the need for careful diagnosis in infant deaths.
Area of Science:
- Neurology
- Pediatric Pathology
Background:
- Cerebral aneurysms are uncommon in infants and young children, with distinct clinical presentations compared to adults.
- Typical symptoms in infants include seizures, loss of consciousness, and apnea, differing from adult symptoms like headaches or visual disturbances.
Observation:
- Morphologic findings such as subarachnoid, retinal, and subdural hemorrhages can be misdiagnosed as inflicted trauma.
- A 7-month-old infant presented with sudden, unexpected death.
Findings:
- The infant's death was attributed to a ruptured complex basilar artery aneurysm.
- This represents the first described case of sudden infant death due to cerebral aneurysm rupture.
Implications:
- Accurate identification of cerebral aneurysms is crucial to prevent misdiagnosis of inflicted trauma in infants.
- This case underscores the importance of considering vascular anomalies in unexplained infant deaths.
Abstract:
Ruptured aneurysms of the cerebrovasculature in infancy and early childhood, except for "giant" aneurysms and arteriovenous malformations, are rare. Seizures, loss of consciousness, and apnea are the usual presenting signs in infancy; symptoms such as headache or visual disturbances and signs such as cranial nerve compression or meningeal irritation commonly found in older children or adults are absent in infants. However, the morphologic findings (i.e., subarachnoid and retinal hemorrhage, and occasionally subdural hemorrhage) may be mistaken for inflicted trauma, especially if the aneurysm is not identified. Sudden death caused by rupture of a cerebral aneurysm has not been previously described in an infant. This report outlines the investigation and autopsy findings in a 7-month-old infant who died unexpectedly as a result of rupture of a complex basilar artery aneurysm.