Intracranial Aneurysms of Childhood

Gerosa, Massimo; Licata, Claudio; Fiore, D.; Iraci, G

doi:10.1159/000119917

Cited by 67 publications

(72 citation statements)

References 6 publications

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“…Os aneurismas em crianças menores de cinco anos, como ocorrido em nosso paciente, são considerados raros e correspondem a menos de 0,1% de todos os aneurismas diagnosticados, sendo mais freqüentes nos dois primeiros anos de vida 5 -1 2 . Existe predomínio do sexo masculino na infância 2-2,8/1, ao contrário do predomínio no sexo feminino observado na idade adulta 1,3,5,7,13 .…”

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“…Menos de 5% dos aneurismas nesta faixa etária são diagnosticados antes dos cinco anos de idade [1][2][3][4] . Apesar da pequena incidência, ressalta-se a gravidade da doença devido a grande ocorrência de ru p t u r a , sendo a principal causa de hemorragia subaracnóidea na infância, 40-52,1% 1,[5][6][7] .…”

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“…Apesar da pequena incidência, ressalta-se a gravidade da doença devido a grande ocorrência de ru p t u r a , sendo a principal causa de hemorragia subaracnóidea na infância, 40-52,1% 1,[5][6][7] .…”

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Aneurisma intracraniano gigante em menino de três anos: relato de caso

Tella

Crosera

Herculano

et al. 2006

Arq. Neuro-Psiquiatr.

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Aneurismas cerebrais são raros na faixa etária pediátrica. A apresentação destas lesões difere significativamente em relação á população adulta no que se refere a tamanho, localização e incidência. Relatamos caso de menimo de três anos de idade que apresentou quadro de hemorragia subaracnóidea sem história de infecções ou traumatismos prévios sendo, posteriormente, diagnosticado aneurisma gigante localizado na artéria cerebral média. Foi submetido a tratamento cirúrgico com boa evolução pós-operatória.

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Aneurisma intracraniano gigante em menino de três anos: relato de caso

Tella

Crosera

Herculano

et al. 2006

Arq. Neuro-Psiquiatr.

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“…5,7,19,21,24,28,32 Aneurysms in the first 2 decades of life account for 1%-4% of all intracranial aneurysms. 12,15,17,29 As in adults, the treatment of intracranial aneurysms in children can involve microsurgical clip ligation, wrapping, and endovascular treatment including flow diversion, coiling, and embolization of the aneurysm and parent vessel.…”

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Rapid de novo aneurysm formation after clipping of a ruptured middle cerebral artery aneurysm in an infant with an MYH11 mutation

Ravindra

Karsy

Schmidt

et al. 2016

PED

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The authors report the case of a previously healthy 6-month-old girl who presented with right arm and leg stiffening consistent with seizure activity. An initial CT scan of the head demonstrated acute subarachnoid hemorrhage in the basal cisterns extending into the left sylvian fissure. Computed tomography angiography demonstrated a 7 × 6 × 5–mm saccular aneurysm of the inferior M2 division of the left middle cerebral artery. The patient underwent left craniotomy and microsurgical clip ligation with wrapping of the aneurysm neck because the vessel appeared circumferentially dysplastic in the region of the aneurysm. Postoperative angiography demonstrated a small remnant, sluggish distal flow, but no significant cerebral vasospasm. Fifty-five days after the initial aneurysm rupture, the patient presented again with an acute intraparenchymal hemorrhage of the left anterior temporal lobe. Angiogram revealed a circumferentially dysplastic superior division of the M2 branch, with a new 5 × 4–mm saccular aneurysm distinct from the first, with 2 smaller aneurysms distal to the new ruptured aneurysm. Endovascular parent vessel occlusion with Onyx was performed. Genetic testing revealed a mutation of the MYH11. To the authors' knowledge, this is the first report of rapid de novo aneurysm formation in an infant with an MYH11 mutation. The authors review the patient's clinical presentation and management and comprehensively review the literature on this topic.

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“…It was demonstrated that large stress from the pulsating blood pre ssure produced structural fatigue in the arterial wall and degenerated the internal elastic lamina 2 5 . The role of hemodynamic factors is clearly illustrated by the preponderance of ICA bifurcation aneurysms is 24 to 50% and only 2.1% in adults 3,6,13 .…”

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Intracranial arterial aneurysms in childhood: case report

Pinto¹,

Valiengo

Santos³

et al. 2006

Arq. Neuro-Psiquiatr.

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-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.

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Intracranial Aneurysms of Childhood

Cited by 67 publications

References 6 publications

Aneurisma intracraniano gigante em menino de três anos: relato de caso

Aneurisma intracraniano gigante em menino de três anos: relato de caso

Rapid de novo aneurysm formation after clipping of a ruptured middle cerebral artery aneurysm in an infant with an MYH11 mutation

Intracranial arterial aneurysms in childhood: case report

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