-A case of an intracranial arterial aneurysm at internal carotid bifurcation in a 10-year-old girl is described with the special features of cerebral aneurysm which occur in children, comparing with the adults. We alert for the necessity of carefully operative technique in order to avoid damage and intraoperative ru p t u re of the aneurysm due to the very thin vessel wall that this population can develop. Our re commendation is early surgery in these patients.KEY WORDS: intracranial aneurysm, pediatric cere b rovascular disease, subarachnoid hemorrhage, childhood.Aneurismas arteriais intracranianos na infância: relato de caso RESUMO -Relatamos o caso de aneurisma arterial intracraniano na bifurcação da carótida interna em menina de 10 anos de idade. As características especiais dos aneurismas intracranianos que acometem a faixa etária pediátrica são descritas, comparando com a faixa etária adulta. Alertamos a necessidade de e m p rego de técnica operatória micro c i r ú rgica cautelosa para evitar lesão e ruptura intraoperatória do aneurisma, devido a parede do aneurisma geralmente ser muito fina na faixa etária pediátrica. Recomendamos cirurgia precoce nestes pacientes.PA L AV R A S -C H AVE: aneurisma intracraniano, doença cere b rovascular pediátrica, hemorragia subaracnóidea, infância. Intracranial aneurysms are rare in childhood, occ u rring at a rate of 0.17 to 4.6% in a population of p atients who have undergone surg e ryfor aneury s m s 1 -4 . The pro p o rtion of ru p t u red aneurysms in patients younger than 15 years is less than 1% 5 . In the pediatric population ru p t u re of aneurysm is a cause of subarachnoid hemorrhage in 18-52.1% 6 , 7 , and several successful operations have been reported 8 . In this re p o rt a case of a 10-year-old girl is described with the special features of cerebral aneury s m which occur in children, comparing with the adults. CASEA 10-year-old girl suddenly presented headache and a syncope episode while she was playing with dolls with her friends. Immediately she was left to hospital. At arrival she was GCS 13, isocoria, with stiff neck, without motor deficits (Hunt-Hess grade 3). At CT was subaracnoid hemorrh a g e (SAH) Fisher grade II and hydrocephalus (Fig 1). MRI showed a n e u rysm flow void (Fig 2) and arteriography showed a right internal carotid art e ry (ICA) bifurcation aneurysm with 4 mm (Fig 3). At the second day of SAH we perf o rmed a pterional approach and the aneurysm was clipped with a single straight clip. The wall of the aneurysm was very thin.In order to control the hydrocephalus, we perf o rm e d the opening of the lamina terminalis.The outcome was excellent and 12 months later the patient is absolutely normal, with normal life activities. P a t i e n t 's mother gave written consent to publish her daughter case.

RESUMO PALAVRAS-CHAVEArq Bras Neurocir 20(3-4): [85][86][87][88][89][90][91][92][93] 2001