12か月の幼児における脳動脈瘤治療におけるフローダイバージョン（血管内治療）の成功例

Pediatric intracranial aneurysms are rare and challenging to manage due to the delicate nature of developing cerebrovasculature. Traditional neurosurgical approaches pose significant risks, particularly in infants. Reconstructive neuroendovascular techniques such as flow diversion have excellent outcomes in the adult population, although data in children are limited. This case report details use of a flow diverting stent in a 12-month-old male presenting with spontaneous subarachnoid hemorrhage due to a dissecting left M2 segment aneurysm. Initial management involved ventriculostomy and coil embolization, but persistent aneurysm filling necessitated additional treatment. Flow diversion was eventually successful. Postoperative management included antiplatelet therapy with aspirin and Plavix. Follow-up imaging at 9 months post procedure confirmed complete obliteration of the aneurysm with preserved vessel integrity. The patient remained neurologically intact without residual deficits. This case underscores the importance of individualized treatment in pediatric neurovascular pathology and highlights the evolving role of flow diversion. It also emphasizes the need for meticulous patient selection and precise endovascular technique. The report contributes valuable insights into the feasibility and safety of flow diversion for pediatric aneurysms, particularly in those as young as 12 months. Nevertheless, further research is needed to establish evidence-based guidelines for managing pediatric aneurysms.