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Multiple ruptured cerebral aneurysms in a child with Takayasu arteritis
Suresh N Magge1, H Isaac Chen, Michael F Stiefel
1Department of Neurosurgery, Children's Hospital of Philadelphia and the Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA. magges@uphs.upenn.edu
Journal of Neurosurgery. Pediatrics
|March 21, 2008
Summary
Takayasu arteritis is a rare cause of ruptured cerebral aneurysms, especially in young children. This case highlights the challenges of managing recurrent aneurysms in an infant diagnosed with this condition.
Area of Science:
- Vascular Neurology
- Pediatric Neurology
- Rheumatology
Background:
- Takayasu arteritis is a rare, chronic inflammatory disease affecting large arteries, primarily the aorta and its branches.
- Cerebral aneurysms are an uncommon manifestation of Takayasu arteritis, with ruptured aneurysms being exceedingly rare in pediatric cases.
Observation:
- An 18-month-old girl presented with a ruptured anterior communicating artery aneurysm.
- The patient was subsequently diagnosed with Takayasu arteritis.
- She experienced multiple, rapid recurrences of aneurysms adjacent to initial surgical clips over six months.
Findings:
- The initial ruptured cerebral aneurysm was treated with clip application.
- Recurrent aneurysms required multiple surgical interventions, including repeat craniotomy and clip application.
- Endovascular coil placement was utilized for subsequent aneurysm management.
Implications:
- This case represents the youngest reported patient with Takayasu arteritis presenting with a ruptured cerebral aneurysm.
- The management of recurrent and rapidly progressing aneurysms in pediatric Takayasu arteritis poses significant clinical challenges.
- Early diagnosis and aggressive management strategies are crucial for improving outcomes in pediatric patients with Takayasu arteritis and associated cerebrovascular complications.
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