Introduction. Despite the contemporary diagnostics of intracranial aneurysms
their treatment is still a great challenge. The decision when and if to
apply a surgical or endovascular treatment of intracranial aneurysms should
be made by a team of medical specialists which consists of a cerebrovascular
neurosurgeon, neuro-radiologist and neuro-anesthesiologist. Case Report. We
report a case of a patient aged 16 who was admitted because of a sudden
intensive headache followed by sickness, vomiting, and loss of
consciousness. On admission the patient was conscious but sleepy. Glasgow
Coma Scale score was 14 and the World Federation of Neurological Surgeons
Scale grade was I. The computed tomography scan showed a massive
subarachnoid haemorrhage. The computed tomography angiography and digital
subtraction angiography revealed a ruptured saccular aneurysm in the left
vertebral artery. An early treatment with the coiling of the lumen of the
aneurysm was performed under general anaesthesia. On the tenth day the boy
was discharged in good condition and without any neurological deficits. Six
months after the intervention the patient was without symptoms and the
control digital subtraction angiography showed the complete occlusion of the
aneurysm. Conclusion. Intracranial aneurysms in children are more common in
males and are predominantly localized in the posterior circulation. In
addition, they are frequently of greater size and more complex architecture
and they are associated with a lower incidence of clinically manifest
vasospasm. According to previous experience, endovascular treatment of
intracranial aneurysms in paediatric patients has proven to be a safe and
efficient method with a small number of complications.
Treatment of pediatric patient with ruptured intracranial aneurysm: Case report
