Posterior Circulation Aneurysms in a Child: Clipping of One Leads to Spontaneous Thrombosis of the Other

Abstract

Multiple intracranial aneurysms in children are infrequent. This case involves an 11-year-old girl who presented with subarachnoid hemorrhage with posterior cerebral and superior cerebellar artery aneurysms. Initially, she underwent clipping of the posterior cerebral artery aneurysm. Four months later, she returned for clipping of the other aneurysm, at which time it was found to have completely thombosed. The literature contains 4 other cases of spontaneous thrombosis of intracranial aneurysms in children, but only one aneurysm <25 mm in size is described. The clinical, surgical, and radiological features of this case and a detailed literature review are presented.

A distal anterior cerebral artery aneurysm in infant: disappearance and reappearance of the aneurysm

“…2;14;15 Spontaneous thrombosis of the cerebral aneurysm Spontaneous thrombosis of a cerebral aneurysm in a child is rare, particularly of a non-giant aneurysm. 16 Nanda and Drury 16 reviewed 28 cases of spontaneously thrombosed aneurysms and stated that the tendency of giant aneurysms to spontaneously thrombose is related to the size ratio of the aneurysm to its neck, haemodynamic considerations and the age of the aneurysm. The role of SAH in spontaneous thrombosis is controversial.…”

“…The role of SAH in spontaneous thrombosis is controversial. 16 Spetzler et al 17 reported an adult case of an aneurysm that repeatedly disappeared and reappeared on serial angiography. Though they hesitated to present a conclusion on the pathogenesis of this phenomenon, they did refer to the possible effect of the e-aminocaproic acid or of marked vasospasm.…”

“…16 Of these, choroid plexus papillomas, metastatic lesions of primarily parenchymal origin with secondary extension into the choroid plexus, and the less common choroid plexus carcinomas account for most tumours. 16;17;26 Particularly rare are solitary metastases to the choroid plexus from extra-neural primary sites.…”