Abstract
Objective: Ruptured cerebral aneurysm is very rare in an infant. We present a case of ruptured posterior cerebral artery aneurysm in a 38-day-old boy.
Case presentation: The infant was brought to the emergency room suffering from lethargy, high grade fever, and subsequent dehydration due to poor oral intake. A head CT before performing lumbar puncture to rule out meningitis showed subarachnoid, intraventricular, and intracerebral hemorrhage, and a round mass in the interpeduncular and crural cisterns. Though MRI and MRA performed after transfer to our hospital could not confirm the mass as an aneurysm, a transfontannelar Doppler study did confirm it by detecting the blood flow within. An aneurysm of the right posterior cerebral artery (PCA) was visualized on conventional angiography thereafter. The aneurysm and parent vessel of the PCA were successfully occluded using a simple coil embolization technique. Postoperatively the infant recovered almost completely, even though diffusion abnormalities were visible in the right occipital lobe on postoperative MRI. The patient was discharged 30 days after the procedure.
Conclusion: Ruptured infantile cerebral aneurysms are rare, and diagnosis is occasionally difficult. In similar rare cases, the success of management depends on maintaining the vigilance of the emergency management team to such a possibility, and the availability of appropriate facilities and skilled neurovascular surgeons.
