GIANT CEREBRAL ARTERIAL ANEURYSM IN AN INFANT - REPORT OF A CASE AND REVIEW OF 42 PREVIOUS CASES IN INFANTS WITH CEREBRAL ARTERIAL ANEURYSM

A giant cerebral aneurysm with subarachnoidal hemorrhage in a 4-month- old female infant is reported. The clinical course was complicated by an electrolyte imbalance and unexpected intoxication by phenobarbital. She died as a result of the third episode of rerupture of the aneurys m on the 16th day after onset. Histological findings showed that the a neurysm was of the saccular type, 35 X 20 X 22 mm in size, arising fro m the basilar artery. The aneurysmal wall consisted microscopically of fibrous tissue with partial absence or fragmentation of the internal elastic lamina and muscular lamina. Forty-three cases of cerebral aneu rysms during the first year of life including the present case were su mmarized and it was found that they could be characterized as follows: (i) a high incidence of onset in early infancy; (ii) larger than 10 m m; (iii) a large number arose from the posterior circulation of the ci rcle of Willis; and (iv) a poor prognosis of non-operated groups, espe cially in the posterior circulation.