Cerebral aneurysms in pediatrics: a case report and review of the literature.

BACKGROUND

Cerebral aneurysms in pediatrics represent < 4% of the total of this condition, and their rupture represents 10-23% mortality. Aneurysms have been associated with infections, head injuries, sickle cell anemia, cardiovascular diseases, autoimmune diseases, immunodeficiencies, and connective tissue diseases. Their clinical presentation includes severe headache, seizures, motor-sensory deficits, and death due to subarachnoid and intraparenchymal hemorrhage.

CASE REPORT: We describe the case of a 12-year-old female patient who presented with a sudden intense headache; after 72 hours, generalized tonic-clonic seizures were observed. At the hospital, she was stabilized with antiepileptic drugs and analgesics. A simple head computed tomography scan showed intraparenchymal hemorrhage in the right frontal lobe and subarachnoid hemorrhage. The study was complemented with a cerebral angiotomography, which revealed an aneurysm of the anterior communicating artery. The pediatric neurosurgeon evaluated the case, and management in the pediatric intensive care unit was decided. Two weeks after the stroke, the aneurysm was clipped and excluded. The patient developed adequate clinical evolution and resolution of initial symptoms, resuming her daily activities.

CONCLUSIONS

Pediatric cerebral aneurysms differ from their adult counterparts, mainly in their etiology and evolution. In addition, pediatric patients have a longer life expectancy. Aneurysm clipping and neurological endovascular therapy have shown similar results.