Rare case of basilar artery aneurysm in a young child

A previously well, 14-month-old girl presented with acute decreased level of consciousness. There was no history of trauma, systemic upset or significant family history. Blood pressure was within normal range and no focal neurological deficit was elicited on examination. Neuroimaging revealed a subarachnoid haemorrhage secondary to a basilar tip aneurysm. Patient underwent endovascular embolisation with good clinical outcome. Follow-up MRI revealed anterior circulation vasospasm, and although clinically asymptomatic, she was treated with a calcium channel antagonist. She was later discharged home with no neurological deficit. Follow-up MRI 3 months following presentation suggested recurrent formation of the aneurysmal sac. The patient then underwent elective endovascular repair 2 months later and was discharged home on antiplatelet therapy with planned close outpatient clinical and radiological surveillance.