1
|
Choi S, Lee SH, Kim K, Kim KM, Cho WS, Kang HS, Kim JE. A child who presented with cerebral infarction: Clipping combined with bypass surgery of a thrombosed giant aneurysm. Surg Neurol Int 2023; 14:115. [PMID: 37151456 PMCID: PMC10159310 DOI: 10.25259/sni_149_2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Accepted: 03/15/2023] [Indexed: 04/03/2023] Open
Abstract
Background:
Cerebral aneurysms are not common among children and most of them are presented with subarachnoid hemorrhage or mass effect. Here, we describe a rare case of a pediatric giant aneurysm presented with cerebral infarction.
Case Description:
A 38-month-old boy visited the emergency room due to left hemiparesis and left central type facial palsy. Initial magnetic resonance imaging showed acute cerebral infarction on the right basal ganglia and coronal radiata. Furthermore, a thrombosed aneurysm with a diameter of 30.57 mm at the frontal branch of the right middle cerebral artery was observed. A right pterional craniotomy with Sylvian dissection was performed. Superior and inferior divisions of the frontal branch originating from the aneurysm were identified. The superior division was cutoff from an aneurysm and clipping saving the inferior division was done. Subsequently, end-to-end anastomosis was done between a parietal branch of the superficial temporal artery and a superior division from the aneurysm. No acute complication from the operation was observed. Motor power of the left upper extremity recovered after rehabilitation, while fine motor impairment remained 6 months after the surgery.
Conclusion:
This case illustrates successful treatment of a pediatric giant aneurysm with extremely rare presentation of cerebral infarction, under a meticulous surgical plan and ad hoc modification.
Collapse
Affiliation(s)
- Sejin Choi
- Department of Neurosurgery, Seoul National University Hospital, Seoul, Korea
| | - Sung Ho Lee
- Department of Neurosurgery, Seoul National University Hospital, Seoul, Korea
| | - Kyunghyun Kim
- Department of Neurosurgery, Seoul National University Children’s Hospital, Seoul, Korea
| | - Kang Min Kim
- Department of Neurosurgery, Seoul National University Hospital, Seoul, Korea
| | - Won-Sang Cho
- Department of Neurosurgery, Seoul National University Hospital, Seoul, Korea
| | - Hyun-Seung Kang
- Department of Neurosurgery, Seoul National University Hospital, Seoul, Korea
| | - Jeong Eun Kim
- Department of Neurosurgery, Seoul National University Hospital, Seoul, Korea
| |
Collapse
|
2
|
Ghali MG, Srinivasan VM, Cherian J, Wagner KM, Chen SR, Johnson J, Lam SK, Kan P. Multimodal Treatment of Intracranial Aneurysms in Children: Clinical Case Series and Review of the Literature. World Neurosurg 2018; 111:e294-e307. [DOI: 10.1016/j.wneu.2017.12.057] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Revised: 12/07/2017] [Accepted: 12/09/2017] [Indexed: 12/18/2022]
|
3
|
Extracranial to intracranial bypass for the treatment of cerebral aneurysms in the pediatric population. J Clin Neurosci 2016; 34:6-10. [DOI: 10.1016/j.jocn.2016.05.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Accepted: 05/08/2016] [Indexed: 11/21/2022]
|