A case of traumatic intracranial aneurysm in a 6-year-old child following a closed blunt head injury

Christopher  O. Concepcion,; Mariz Kaye  Sales,; Asis  Encarnacion,

A case of traumatic intracranial aneurysm in a 6-year-old child following a closed blunt head injury

Mariz Kaye Sales | Christopher O Concepcion | Asis Encarnacion

Abstract:

This is a case of a 6-year-old male who had a motor vehicular accident, who initially presented without neurologic deficit immediately post injury but followed up with seizures and motor weakness. The aim of the study is to review the pathomechanism of traumatic aneurysm in blunt head trauma in pediatric patients. The initial imaging done revealed a closed, depressed comminuted fracture in the left frontal bone. Three weeks post-injury, he had recurrent generalized tonic clonic seizures and angiogram showed saccular aneurysm of the left A2 with left frontal intracerebral hemorrhage (ICH). The patient underwent bifrontal craniotomy, clipping of aneurysm and evacuation of the ICH. Treatment options includes endovascular approach, wrapping and trapping the aneurysm. However, there is no single modality indicated for all lesions. Post-operatively, the patient was aphasic with right hemiparesis (2/5). Speech improved the second week after the surgery. Rehabilitation was initiated after admission and unassisted ambulation noted after 2 months. Work up done for other possible causes of aneurysm in the pediatric population revealed unremarkable findings. Mechanism associated with blunt traumatic head injury in the development of aneurysm could be secondary to a shear or rotational injury damaging vessels in close proximity to dura, for instance in this case, close to the falx cerebri.

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