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Published on: September 25, 2009
A ruptured middle cerebral artery aneurysm in a 13-month-old boy with Kawasaki disease
Jun Hyong Ahn1, Ji Hoon Phi, Hyun-Seung Kang
1Division of Pediatric Neurosurgery, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea.
Insights
This case report details a pediatric subarachnoid hemorrhage in a 13-month-old due to a ruptured middle cerebral artery aneurysm, a rare complication of Kawasaki disease, termed Kawasaki syndrome.
Area of Science:
- Pediatric Neurology
- Neurovascular Surgery
- Rheumatology
Background:
- Kawasaki disease is a systemic vasculopathy primarily affecting medium-sized arteries.
- Intracranial aneurysms in children are rare, with varied associated systemic conditions.
- Cerebral artery involvement is uncommon in Kawasaki disease.
Observation:
- A 13-month-old boy with a history of Kawasaki disease presented with subarachnoid hemorrhage.
- Rupture of a middle cerebral artery aneurysm was identified as the cause.
- The aneurysm was partially thrombosed and required emergency surgical intervention.
Findings:
- Emergency craniectomy and clip occlusion of the ruptured middle cerebral artery aneurysm were successfully performed.
- The patient recovered without apparent neurological deficit and was discharged after 4 weeks.
- This represents the second reported case of a ruptured cerebral aneurysm in a patient with Kawasaki disease.
Implications:
- This case highlights a rare but severe neurovascular complication of Kawasaki disease.
- The authors propose the term "Kawasaki syndrome" for this specific clinical presentation.
- Further research is warranted to understand the link between Kawasaki disease and cerebral aneurysms.
Abstract:
This 13-month-old boy, in whom Kawasaki disease had been diagnosed at the age of 6 months, presented with subarachnoid hemorrhage caused by the rupture of a middle cerebral artery aneurysm. The authors performed an emergency craniectomy and clip occlusion of the aneurysm, which was found to be partially thrombosed. The patient was discharged 4 weeks postoperatively without apparent neurological deficit. Intracranial saccular aneurysms in the pediatric population are rare, and are occasionally associated with various systemic disorders. Kawasaki disease is a systemic vasculopathy of unknown origin, but cerebral arteries are usually spared from the disease process. This is the second case report of a ruptured cerebral aneurysm in a patient with Kawasaki disease, providing a novel clinical feature that the authors call Kawasaki syndrome.
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