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Minimally Invasive Thumb-sized Pterional Craniotomy for Surgical Clip Ligation of Unruptured Anterior Circulation Aneurysms
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Minimally Invasive Thumb-sized Pterional Craniotomy for Surgical Clip Ligation of Unruptured Anterior Circulation Aneurysms

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Treatment of pediatric patient with ruptured intracranial aneurysm--case report

Igor Meljnikov1, Petar Vuleković, Tomislav Cigić

  • 1Department of Pediatric Surgery, Institute for Child and Youth Health Care of Vojvodina, Novi Sad. igor.meljnikov@gmail.com

Medicinski Pregled
|August 29, 2012
PubMed

Insights

Endovascular coiling offers a safe and effective treatment for ruptured intracranial aneurysms in pediatric patients, leading to excellent outcomes and complete aneurysm occlusion. This minimally invasive approach is crucial for managing complex cerebrovascular cases in young individuals.

Area of Science:

  • Neurology
  • Neurosurgery
  • Radiology

Background:

  • Intracranial aneurysms present significant treatment challenges, necessitating multidisciplinary specialist decision-making.
  • Pediatric intracranial aneurysms are more prevalent in males, often larger, complex, and located in the posterior circulation.

Observation:

  • A 16-year-old male presented with subarachnoid hemorrhage due to a ruptured left vertebral artery saccular aneurysm.
  • Initial presentation included severe headache, nausea, vomiting, and decreased consciousness (Glasgow Coma Scale 14, WFNS Grade I).

Findings:

  • Computed tomography angiography and digital subtraction angiography confirmed the ruptured saccular aneurysm.
  • Endovascular coiling was successfully performed under general anesthesia, achieving early aneurysm occlusion.
  • The patient was discharged on day 10 with no neurological deficits and remained asymptomatic at 6-month follow-up with complete aneurysm occlusion.

Implications:

  • Endovascular treatment is a safe and efficient method for pediatric intracranial aneurysms, associated with a low complication rate.
  • Early intervention with coiling can lead to favorable outcomes, including complete recovery and absence of neurological deficits in young patients.
  • This case highlights the successful application of endovascular techniques in managing complex cerebrovascular conditions in adolescents.
Abstract

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