Cerebral artery aneurysms in infancy, childhood and adolescence

From this series of 16 cerebral artery aneurysms in the paediatric age group the following points can be made: (a) aneurysms in the paediatric age group may be found in unusual locations, more peripherally than usually seen in the adult population, (b) in seven patients, the aneurysm was of giant size; two of these produced symptoms by mass effect, (c) in two patients with subacute bacterial endocarditis the aneurysm was mycotic; the inflammatory fusiform dilatation of the entire circle of Willis in one case was associated with generalized candidiasis, (d) an antecedent head injury in a child may so prejudice the initial clinical assessment that the possibility of haemorrhage from aneurysm is overlooked, and (e) gradual vertebral artery ligation, to reduce the pressure-head in fusiform aneurysms, is well tolerated by the young patient, even when done bilaterally.