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Updated: Jul 7, 2026
Microsurgical Clip Obliteration of Middle Cerebral Aneurysm Using Intraoperative Flow Assessment
Published on: September 25, 2009
Microsurgical clipping of large MCA aneurysm in a 2-month-old child
Anurag Srivastava1, Yogesh Kaushik2, Tshering Dorjee Sherpa3
1Department of Neurosurgery, Mahatma Gandhi Hospital, Jaipur, Rajasthan, India.
Insights
Pediatric cerebral aneurysms are rare but can cause severe symptoms like seizures. This case highlights successful microsurgical clipping of a middle cerebral artery aneurysm in a 2-month-old infant.
Area of Science:
- Pediatric Neurosurgery
- Cerebrovascular Diseases
- Neuroradiology
Background:
- Cerebral aneurysms in children are rare, accounting for <4% of all cases.
- Etiology and presentation in pediatric cerebral aneurysms differ from adults.
- Common symptoms include severe headache, seizures, and focal neurological deficits.
Observation:
- A 2-month-old male presented with persistent generalized tonic-clonic seizures.
- Initial imaging revealed intraparenchymal and subarachnoid hemorrhage.
- CT angiogram identified an aneurysm in the left middle cerebral artery (MCA) M3 segment.
Findings:
- The patient underwent successful microsurgical clipping of the MCA aneurysm.
- Hematoma evacuation was performed concurrently.
- The infant was stabilized with ventilatory support, sedation, and antiepileptic drugs.
Implications:
- This case underscores the importance of timely diagnosis and intervention for pediatric cerebral aneurysms.
- Microsurgical clipping is an effective treatment option for pediatric aneurysms.
- Further research into the unique aspects of pediatric cerebral aneurysms is warranted.
Background:
Cerebral aneurysms in children have a low incidence and accounts for less than 4% of all cerebral aneurysms. These aneurysms have been linked to various factors. Severe headache, seizures, and motor-sensory deficits are common presentations.
Case Report:
We describe the case of a 2-month-old male patient who presented with generalized tonic-clonic seizures for 4 days. At the hospital, he was stabilized with ventilatory support, sedation, and antiepileptic drugs. A NCCT (Head) showed intraparenchymal hemorrhage in the left fronto-parieto-temporal lobe and subarachnoid hemorrhage. Subsequently a CT angiogram revealed an aneurysm of the left M3 segment of MCA. Successfully, the patient underwent microsurgical clipping of aneurysm and evacuation of hematoma.
Conclusions:
Pediatric cerebral aneurysms differ from their adult counterparts, mainly in their etiology and evolution. As per literature, aneurysmal clipping and neurological endovascular therapy have shown similar results.
