A Large traumatic middle cerebral artery aneurysm in a Child: case report and review of literature





Dissecting aneurysm, middle cerebral artery, endovascular, pediatric aneurysms


A 6-year-old girl presented with a very large aneurysm of the distal branch of middle cerebral artery( angular artery). There was a previous history of mild traumatic brain injury. The presentation happened more than 5 weeks after the trauma with an  atypical visual complaint. She was successfully treated by embolization and occlusion of the parental vessel. Recognizing pos traumatic aneurysm is a challenging in young child and must be remembered in patients with a recent traumatic event. Endovascular treatment is a good option when the occlusion of the artery is possible in the presence of a good collateral circulation.


Key-words: Dissecting aneurysm; middle cerebral artery; endovascular; pediatric aneurysms


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Koyama S, Kotani A, Sasaki J. Spontaneous dissecting aneurysm of the anterior cerebral artery: report of two cases. Surg Neurol. 1996;46(1):55-61.

Pinto FC, Valiengo L, Santos PP, Matushita H, Plese JP. Intracranial arterial aneurysms in childhood: case report. Arquivos de neuro-psiquiatria. 2006;64(3A):676-80.

Xu R, Xie ME, Yang W, Gailloud P, Caplan JM, Jackson CM, et al. Epidemiology and outcomes of pediatric intracranial aneurysms: comparison with an adult population in a 30-year, prospective database. J Neurosurg Pediatr. 2021:1-10.

Krings T, Geibprasert S, terBrugge KG. Pathomechanisms and treatment of pediatric aneurysms. Childs Nerv Syst. 2010;26(10):1309-18.

Nash M, Rafay MF. Craniocervical Arterial Dissection in Children: Pathophysiology and Management. Pediatr Neurol. 2019;95:9-18.

Hejrati N, Ebel F, Guzman R, Soleman J. Posttraumatic cerebrovascular injuries in children. A systematic review. Childs Nerv Syst. 2020;36(2):251-62.

Urasyanandana K, Songsang D, Aurboonyawat T, Chankaew E, Withayasuk P, Churojana A. Treatment outcomes in cerebral artery dissection and literature review. Interv Neuroradiol. 2018;24(3):254-62.

Buckingham MJ, Crone KR, Ball WS, Tomsick TA, Berger TS, Tew JM, Jr. Traumatic intracranial aneurysms in childhood: two cases and a review of the literature. Neurosurgery. 1988;22(2):398-408.

Fullerton HJ, Johnston SC, Smith WS. Arterial dissection and stroke in children. Neurology. 2001;57(7):1155-60.

Bechan RS, van Rooij WJ. Endovascular treatment of a ruptured flow aneurysm of the heubner artery as part of a moyamoya collateral network in a young patient with an occluded middle cerebral artery. Interv Neuroradiol. 2014;20(6):791-5.

Chamoun RB, Jea A. Traumatic intracranial and extracranial vascular injuries in children. Neurosurg Clin N Am. 2010;21(3):529-42.

Silva Neto AR, Camara RL, Valenca MM. Carotid siphon geometry and variants of the circle of Willis in the origin of carotid aneurysms. Arquivos de neuro-psiquiatria. 2012;70(12):917-21.

Requejo F, Ceciliano A, Cardenas R, Villasante F, Jaimovich R, Zuccaro G. Cerebral aneurysms in children: are we talking about a single pathological entity? Childs Nerv Syst. 2010;26(10):1329-35.

Rhoton AL, Jr. The supratentorial arteries. Neurosurgery. 2002;51(4 Suppl):S53-120.

Kim M, Lee HS, Lee S, Park JC, Ahn JS, Kwon DH, et al. Pediatric Intracranial Aneurysms: Favorable Outcomes Despite Rareness and Complexity. World Neurosurg. 2019;125:e1203-e16.

O'Neal CM, Ernst GL, Hughes KL, Stephens TM, Hendrix MC, Gross NL, et al. Reported incidence and treatment modalities of giant cerebral aneurysms in the pediatric population: A systematic review and illustrative case report. J Clin Neurosci. 2021;90:14-20.

Fleischer AS, Patton JM, Tindall GT. Cerebral aneurysms of traumatic origin. Surg Neurol. 1975;4(2):233-9.

Chen R, Zhang S, Guo R, Ma L, You C. Pediatric intracranial distal arterial aneurysms: report of 35 cases. Acta Neurochir (Wien). 2018;160(8):1633-42.

terBrugge KG. Neurointerventional procedures in the pediatric age group. Childs Nerv Syst. 1999;15(11-12):751-4.

Vargas SA, Diaz C, Herrera DA, Dublin AB. Intracranial Aneurysms in Children: The Role of Stenting and Flow-Diversion. J Neuroimaging. 2016;26(1):41-5.

Cherian J, Srinivasan V, Froehler MT, Grossberg JA, Cawley CM, Hanel RA, et al. Flow Diversion for Treatment of Intracranial Aneurysms in Pediatric Patients: Multicenter Case Series. Neurosurgery. 2020;87(1):53-62.




How to Cite

Silva Neto A, Alves FAS, Dantas MCS, Lima FRV, da Cunha GG, Moura FA de A. A Large traumatic middle cerebral artery aneurysm in a Child: case report and review of literature. Arch Pediat Neurosurg [Internet]. 2022 Jan. 31 [cited 2022 May 17];4(1(January-April):e1182022. Available from: https://archpedneurosurg.com.br/pkp/index.php/sbnped2019/article/view/118

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