Escobar-de la Garma VH, de Montesinos-Sampedro A, Padilla-Vázquez F, Ramírez-Aguilar R, Mendizábal-Guerra R

Language: Spanish
References: 17
Page: -211-215
PDF size: 196.32 Kb.

ABSTRACT

The prevalence of intracranial aneurysms in children counts for 1-2% of all cases. There is male predominance and the most common location is bifurcation of internal carotid artery. Microsurgical and endovascular treatment have been described with good results in both cases. We present the experience in one case and literature review. Case report: ee present the case of an 11-year male with normal psychomotor development, and apparently healthy parents. He had history of sudden headache associated with nausea and vomiting two weeks before he was treated in our institution. This clinical picture was accompanied by an episode of generalized seizures and posterior drowsiness. He received medical treatment in regional hospital and posteriorly moved to our hospital were we evaluated him finding Glasgow Coma Scale 15, Hunt and Hess 1 and mild right hemiparesia. Initial CT scan done two weeks earlier revealed a Fisher III subarachnoid hemorrhage with predominance of blood in left basal cisterns. MRI with vascular reconstruction performed in our hospital showed saccular small aneurysm (4 x 2 mm) with narrow neck of 2mm located in the bifurcation of left internal carotid artery. Microsurgical clipping was done through a pterional approach succesfully. He showed recovery of motor symptoms. Six months later cerebral angiogram showed no evidence of residual aneurysm. Conclusion: Intracranial Aneurysm clipping in childhood is a safe and feasible procedure with good long term results. Due to the lack of enough sample size, clinical trials are needed to clarify the benefits of endovascular versus microsurgical treatment, however, both of them seem to have similar results in this population, although microsurgical procedures are claimed to be a safer, definite and more durable form of treatment.

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