Affiliations: Department of Pediatrics, Floating Hospital for
Children at Tufts Medical Center, Boston, MA, USA | Department of Neurology, Tufts Medical Center, Boston, MA, USA | Department of Neurosurgery, Tufts Medical Center, Boston, MA, USA
Note: [] Correspondence: Dimitrios Arkilo, 800 Washington Street, box
#330, Boston, MA 02111, USA. Tel.: +1 516 851 3839; Fax: +1 617 636 8375;
E-mail: arkdimi@hotmail.com
Abstract: We report an 8-year-old female who developed left abducens nerve
palsy and progressively enlarging left internal carotid aneurysm in the setting
of sphenoid sinusitis. Despite conservative management with antibiotics and
antiplatelet agent, she developed enlargement of the aneurysm with embolic
stroke. For that reason, she underwent occlusion of her left internal carotid
artery with coiling, after confirmation of good collateral circulation. The
patient tolerated the procedure well, with improvement of her symptoms. To our
knowledge, this is the first report documenting good neurological outcome after
elective internal carotid occlusion. Due to lack of guidelines, management of
aneurysms secondary to infection should be individualized, based on collateral
circulation and risk of intervention.
