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Microsurgical Clip Obliteration of Middle Cerebral Aneurysm Using Intraoperative Flow Assessment
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Infantile traumatic pericallosal aneurysm: illustrative case

Zachary S Hubbard, Conor M Cunningham, Brian F Saway

    Journal of Neurosurgery. Case Lessons
    |March 11, 2024
    PubMed

    Insights

    Traumatic aneurysms, a rare consequence of nonaccidental head trauma (NAT) in infants, require consideration in abusive head trauma evaluations. Early identification and treatment are crucial for better outcomes in these challenging pediatric cases.

    Area of Science:

    • Pediatric Neurosurgery
    • Neuroradiology
    • Pediatric Critical Care

    Background:

    • Traumatic aneurysms are a rare but serious complication of nonaccidental head trauma (NAT) in infants.
    • The incidence of NAT in children is rising, increasing the importance of considering traumatic aneurysms in evaluations.
    • These aneurysms are a significant concern in pediatric patients presenting with signs of abusive head trauma.

    Purpose of the Study:

    • To highlight the occurrence and management of traumatic intracranial aneurysms in infants secondary to abusive head trauma.
    • To emphasize the diagnostic challenges and poor prognosis associated with these injuries.

    Main Methods:

    • Case presentation of a 24-day-old infant with symptoms of neurological distress.
    • Diagnosis of bilateral subdural hematomas, contusions, and subarachnoid hemorrhage.
    • Identification of a right pericallosal traumatic aneurysm via magnetic resonance angiography.
    • Treatment of the aneurysm using coil and Onyx embolization.

    Main Results:

    • The infant presented with signs of abuse, including subdural hematomas and contusions.
    • Magnetic resonance angiography confirmed a right pericallosal traumatic aneurysm.
    • The traumatic aneurysm was successfully treated with endovascular embolization.

    Conclusions:

    • Traumatic intracranial aneurysms are a rare but critical finding in pediatric abusive trauma.
    • These aneurysms should be suspected in cases of high-energy trauma with associated intracranial pathology.
    • Despite advancements, the identification and treatment of traumatic aneurysms in infants remain challenging, with a guarded prognosis due to diffuse injuries.
    Abstract

    Keywords:
    aneurysmcerebrovascular traumaneurotraumapediatricstraumatic cerebral aneurysm

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