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Título

Clinical Case: Dissecting Aneurysm Of The Middle Cerebral Artery In A Three-Month-Old Infant: Case Report

RESUMO

CASE PRESENTATION: A 3-month-old female infant with a report of her first seizure in her life. On examination, he was in good general condition, normotensive anterior fontanelle, without neck stiffness and afebrile. Normal cardiopulmonary auscultation and abdomen without a palpable mass. Previous history: Late premature (34 weeks and 2 days), vaginal delivery with meconium amniotic fluid. There was a prolonged hospital stay due to proximal jejunal atresia, and she underwent corrective surgery on her 10th day of life. No history of infection or previous trauma. Cerebral aneurysm embolization with detachable platinum microcoils was chosen, using a total of 10 units. Control angiography showed aneurysmal occlusion with preserved filling of distal branches of the right MCA. The postoperative evolution was satisfactory, and the patient was discharged on the 3rd postoperative day. DISCUSSION: Cerebral aneurysms are rare in pediatric patients. In relation to the adult population, its presentation differs in terms of incidence, size and location. Despite its low incidence, 95% of the cases have subarachnoid hemorrhage as the initial manifestation, giving high morbidity and mortality to patients. Among the risk factors of the pediatric population, trauma and mycotic aneurysms, in terms of acquired pathologies, deserve to be highlighted; and family history and collagen diseases (Elher-Danlos, Marfan syndrome, Type I neurofibromatosis and polycystic kidney disease) and congenital pathologies. In the case reported, we did not identify associated risk factors. FINAL COMMENTS: Due to the lower incidence of intracranial aneurysms in the pediatric population, the scientific literature lacks robust evidence pointing to the best therapeutic option. Our case aims to contribute to the scientific literary scope as evidence of a successful endovascular approach.