Endovascular management of a ruptured complex ACoM aneurysm in a 9-month-old infant: a rare case report and literature review.

Ruptured intracranial aneurysms in infants are exceptionally rare, particularly saccular aneurysms of the anterior communicating artery (ACoM). We report a 9-month-old infant presenting with subarachnoid and intraventricular hemorrhage due to a ruptured complex ACoM aneurysm, along with two small right A2 saccular aneurysms. The child underwent successful balloon-assisted endovascular coiling, with clinically silent vasospasm and full neurological recovery. To our knowledge, this is the first reported case of a ruptured infantile saccular ACoM aneurysm treated with endovascular coiling resulting in a good functional outcome. This case supports the feasibility of endovascular treatment in selected pediatric aneurysm cases.