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Related Experiment Videos

Dissecting giant vertebro-basilar aneurysms.

Luca Massimi1, Jacques Moret, Giampiero Tamburrini

  • 1Pediatric Neurosurgery, Catholic University School of Medicine, Largo A. Gemelli, 8, 00168 Rome, Italy. lucamax30@hotmail.com

Child'S Nervous System : Chns : Official Journal of the International Society for Pediatric Neurosurgery
|April 26, 2003
PubMed
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Giant vertebro-basilar dissecting aneurysms (VDAs) are rare in children. Endovascular embolization is a viable treatment option, but carries risks, as demonstrated by this case report.

Area of Science:

  • Pediatric Neurology
  • Vascular Neurosurgery
  • Interventional Neuroradiology

Background:

  • Vertebro-basilar dissecting aneurysms (VDAs) are exceptionally rare in pediatric populations.
  • Clinical presentations can be non-specific, complicating early diagnosis.
  • Intracranial mass effect is an unusual manifestation of pediatric VDAs.

Observation:

  • An 8-year-old girl presented with progressive neurological deficits including hemiparesis, ataxia, dysphagia, and dysphonia.
  • Neuroimaging revealed a giant dissecting aneurysm originating from the left vertebral artery, extending to the vertebro-basilar junction.
  • The patient exhibited symptoms indicative of significant intracranial mass effect.

Findings:

  • Endovascular treatment using coil embolization was performed for the giant VDA.

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  • Initial post-operative recovery showed marked clinical improvement.
  • The patient subsequently developed a fatal cerebral hemorrhage.

    • Implications:

    • Pediatric VDAs can present atypically, posing diagnostic and therapeutic challenges.
    • Endovascular embolization is a potential treatment modality for pediatric VDAs.
    • Despite treatment, significant risks, including mortality, persist with interventions for VDAs.