Infantile traumatic pericallosal aneurysm: illustrative case.

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.