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Infantile cerebral aneurysms with visual pathway compression
R Huna-Baron1, R L Lesser, F A Warren
1Goldschleger Eye Institute, Sheba Medical Center, Tel-Hashomer, Israel.
Insights
Infantile cerebral aneurysms are rare but can present with mass effect symptoms like macrocephaly or strabismus, differing from adult presentations. Early recognition is crucial for prompt diagnosis and management of these uncommon pediatric vascular lesions.
Area of Science:
- Pediatric Neurology
- Neuroradiology
- Vascular Neurology
Background:
- Intracranial aneurysms are uncommon in infants, with intracranial hemorrhage being the most frequent presentation.
- Infantile aneurysms may exhibit mass effect signs more often than adult counterparts.
Observation:
- Two infants presented with cerebral aneurysms, one with macrocephaly and the other with strabismus.
- Both infants experienced visual loss and optic disc pallor.
- MRI revealed suprasellar masses causing anterior visual pathway compression, leading to a preoperative diagnosis of craniopharyngioma in both cases.
Findings:
- Cerebral aneurysms in infants can mimic other pediatric suprasellar masses like craniopharyngioma.
- Mass effect symptoms, including visual disturbances and optic nerve compression, are significant in infantile aneurysms.
Implications:
- Highlights the importance of considering cerebral aneurysms in the differential diagnosis of infants presenting with visual loss and signs of intracranial mass effect.
- Emphasizes the distinct clinical and radiological features of infantile cerebral aneurysms compared to adults.
- Underscores the need for advanced neuroimaging to differentiate aneurysms from other pediatric brain tumors.
Abstract:
Intracranial aneurysms are rare in infancy. The commonest presentation is intracranial hemorrhage, but signs of mass effect are more frequent than in adults. We report 2 infants with cerebral aneurysms, one presenting with macrocephaly and another with strabismus. Both had visual loss and optic disc pallor; MRI revealed a suprasellar mass and anterior visual pathway compression. In both cases, the preoperative diagnosis was craniopharyngioma. It is essential to recognize that, although exceedingly uncommon, cerebral aneurysms do occur in infants and have features that differ from those in adults.