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Child's Nervous System
Published in: Child's Nervous System 8/2009

01-08-2009 | Case Report

Neonatal ruptured intracranial aneurysms: case report and literature review

Authors: Y. Van Raay, S. Darteyre, F. Di Rocco, J. Goodden, M. Papouin, F. Brunelle, C. Sainte-Rose, M. Zérah

Published in: Child's Nervous System | Issue 8/2009

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Abstract

Introduction

Intracranial aneurysms are exceptional in neonatal patients: There are only 16 cases previously reported. We describe the first case of neonatal posterior inferior cerebellar artery (PICA) aneurysm and review the literature.

Case report

A 7-day-old girl presented with irritability, anorexia, fever and abnormally enlarging head circumference. Computed tomography (CT) and magnetic resonance (MR) imaging demonstrated intraventricular haemorrhage, secondary hydrocephalus and a pontine cistern haematoma. A PICA aneurysm was suspected on the CT angiogram (CTA) and the diagnosis was confirmed by conventional cerebral angiography. She was successfully treated by surgical clipping of the parent vessel and excision of the aneurysm. Postoperatively, she experienced transient swallowing difficulties and required a ventriculo-peritoneal shunt for hydrocephalus. Histopathological evaluation demonstrated a calcified arterial wall with thrombosis, signs of prior haemorrhage and the absence of the internal elastic lamina.

Conclusion

Neonatal intracranial aneurysms are rare. Clinical presentation of subarachnoid haemorrhage in this age group is often non-specific. First-line investigation should start with transfontanelle cranial ultrasound, followed by MR angiography then CTA if necessary. Posterior circulation aneurysms and large or giant aneurysms are more frequent in neonates and children than in adults. Early diagnosis and treatment are important for improved outcome. Surgery is better tolerated than in adults.
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Metadata
Title
Neonatal ruptured intracranial aneurysms: case report and literature review
Authors
Y. Van Raay
S. Darteyre
F. Di Rocco
J. Goodden
M. Papouin
F. Brunelle
C. Sainte-Rose
M. Zérah
Publication date
01-08-2009
Publisher
Springer-Verlag
Published in
Child's Nervous System / Issue 8/2009
Print ISSN: 0256-7040
Electronic ISSN: 1433-0350
DOI
https://doi.org/10.1007/s00381-009-0871-1

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