Occult aneurysmal hemorrhage in a child - Case report and literature review

A unique case of the diagnosis and treatment of a ruptured cerebral aneurys m in a 5-year-old male is presented. The child presented with subarachnoid hemorrhage, and initial CT imaging indicated a right posterior communicatin g artery aneurysm. Cerebral angiography and MRI/MRA were normal, Repeat cer ebral angiogram 3 weeks later was also normal. Sixteen months later, an ang iogram was performed to evaluate a subtle carotid bruit found on exam, A ca rotid bifurcation aneurysm pointing inferior and posterior was found. Crani otomy to clip the aneurysm was performed, and marked adherent gliosis aroun d the lesion was found, supporting the fact that this was the causal lesion of his bleed in the past, Albeit a single case report, it underscores the need for very long-term follow-up and evaluation of idiopathic pediatric su barachnoid hemorrhage. Copyright (C) 2001 S,Karger AG. Basel.