Affiliations: Department of Neurosurgery, Sanjay Gandhi,
Postgraduate institute of Medical Sciences, Lucknow, India
Note: [] Correspondence: Raj Kumar, M.D., Department of Neurosurgery,
Sanjay Gandhi Postgraduate, Institute of Medical Sciences, Lucknow -226014,
U.P., India. Tel.: +91 522 2668700, 2668800 Ext. 2157(C), 2158(R), 2107(OT),
2741(O); Fax: +91 522 2668129 & 2668017; E-mail: rajkumar@sgpgi.ac.in
Abstract: Intracranial aneurysms are extremely uncommon in children
(⩽ 18 years old) and their incidence increases with age.
Their epidemiology is poorly understood and certain features like location,
morphology and presentation make them unique in comparison to adults. The
internal carotid artery bifurcation is the most frequent site for aneurysm in
this age group. We report a case of an 8-year-old boy with history of sudden
unconsciousness followed by generalized tonic clonic seizures. The computerized
tomography scan revealed subarachnoid hemorrhage with blood seen in the left
Sylvian fissure, along tentorium cerebelli and posterior falx. There was focal
intracerebral hematoma in the left temporal lobe abutting the Sylvian fissure
and blood could also be seen in the fourth, third and both lateral ventricles
with mild ventriculomegaly. The digital subtraction angiography revealed a
large intracranial aneurysm arising from the left proximal anterior cerebral
artery just distal to left internal carotid artery bifurcation. The aneurysm
was clipped using standard microsurgical techniques. The child did well
postoperatively. Intracranial aneurysms are rare in childhood and proximal
artery anterior cerebral artery aneurysms are amongst the rarer sites. This
report highlights one such rare case.
