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Multiple middle cerebral artery aneurysms in an infant. Case report
C Cedzich1, J Schramm, G Röckelein
1Neurosurgical Clinic, University of Erlangen-Nuernberg, West Germany.
Insights
A rare case of multiple middle cerebral artery aneurysms in an infant presented with neurological symptoms. Surgical intervention successfully treated the condition, highlighting successful pediatric neurovascular treatment.
Area of Science:
- Pediatric Neurology
- Vascular Neurosurgery
- Cerebral Aneurysm Research
Background:
- Multiple cerebral aneurysms are exceptionally rare in infants.
- Intracranial hemorrhage in children necessitates prompt diagnosis and management.
Observation:
- An 11-month-old boy presented with acute neurological symptoms including drowsiness, vomiting, and convulsions.
- Imaging revealed subarachnoid hemorrhage and an intracerebral hematoma, with angiography identifying multiple aneurysms on the left middle cerebral artery (MCA).
Findings:
- Surgical exploration identified 13 aneurysms originating from a single MCA branch.
- The affected MCA segment was surgically trapped, with no intraoperative neurological compromise indicated by somatosensory evoked potentials.
- Histological examination of the diseased arterial segment provided insights into pathogenesis.
Implications:
- This case underscores the possibility of MCA aneurysms in infancy and the potential for successful surgical outcomes.
- The successful management highlights the importance of advanced neuroimaging and surgical techniques in pediatric neurovascular disease.
- Further research into the etiology and long-term outcomes of pediatric cerebral aneurysms is warranted.
Abstract:
An 11-month-old boy was admitted for evaluation of drowsiness, vomiting, and convulsions. Computerized tomography showed subarachnoid blood in the left sylvian fissure and a small intracerebral hematoma in the temporal lobe. Angiography revealed several aneurysms of the left middle cerebral artery (MCA). During surgery, 13 aneurysms were found arising from one main branch of the left MCA, and this segment of the MCA was trapped. Somatosensory evoked potentials did not show any change during surgery. The diseased arterial segment was examined histologically and the pathogenetic aspects of the case are discussed. Control angiography 6 months later excluded systemic disease or other aneurysms. The rarity of such lesions in childhood and their successful surgical treatment are discussed briefly.