Neonatal ruptured intracranial aneurysms: case report and literature review
| Autor: | Michel Zerah, Francis Brunelle, Y. Van Raay, M. Papouin, F. Di Rocco, Christian Sainte-Rose, S. Darteyre, J. Goodden |
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| Rok vydání: | 2009 |
| Předmět: |
Male
medicine.medical_specialty Treatment outcome Diagnosis Differential Aneurysm X ray computed medicine.artery medicine Humans cardiovascular diseases Pica (disorder) medicine.diagnostic_test business.industry Infant Newborn Brain Magnetic resonance imaging Intracranial Aneurysm General Medicine medicine.disease Magnetic Resonance Imaging Surgery Cerebral Angiography Posterior inferior cerebellar artery Treatment Outcome Pediatrics Perinatology and Child Health cardiovascular system Female Neurology (clinical) Radiology Neurosurgery Cerebral Arterial Diseases medicine.symptom business Tomography X-Ray Computed Cerebral angiography Hydrocephalus |
| Zdroj: | Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery. 25(8) |
| ISSN: | 1433-0350 |
| Popis: | 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.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.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. |
| Databáze: | OpenAIRE |
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