2013, Number 5
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Bol Med Hosp Infant Mex 2013; 70 (5)
Carotid apex aneurysms in children. Case report
Palomera GHG, Uribe OJS, Alcántara GLA, Zambrano VLE, Gómez LE, González PEA, Quillo OJ, Velázquez SH
Language: Spanish
References: 14
Page: 387-391
PDF size: 186.33 Kb.
ABSTRACT
Background. Aneurysm malformations of the circle of Willis comprise a rare group of congenital anomalies that occur during the pediatric age and are a major cause of morbidity and mortality in this age group. Consequently, management of these lesions is complex and potentially lethal and may pose problems for the patient and affect their treatment.
Case report. We report the case of a 10-year-old girl who had a sudden onset of neurogenic syncope and tonic-clonic seizures. After arriving at the emergency room she underwent a CT scan, identifying a Fisher II subarachnoid hemorrhage. Four-vessel cerebral angiography identified apex saccular carotid injury ~5.1 x 7.2 mm with visible neck and dome partially cephalic and partially frontal. Right frontopterional craniotomy was performed and preclipping during transsurgical ultrasound was performed, identifying the aneurysmal lesion and postclipping to verify patency of the distal branches to clipping.
Conclusions. Aneurysmal malformations in children are extremely rare. For this reason, methods such as endoscopy and trans- and postoperative ultrasound are very useful. These procedures sometimes reveal details that conventional imaging studies do not, determining use of a procedure with less risk of morbidity and mortality for these patients.
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