This case illustrates the typical features of saccular aneurysms occur
ring in children under the age of 5 years, The child was male and pres
ented with a subarachnoid/intracerebral haemorrhage secondary to a lar
ge ruptured saccular aneurysm of the distal middle cerebral artery. Su
rgical management was undertaken and despite an initial poor clinical
grade, the baby has enjoyed an excellent clinical outcome, The clinica
l features of the case, histology of the aneurysm and review of the li
terature are presented.