Implantation of two flow diverter devices in a child with a giant, fusiform vertebral artery aneurysm: case report

Abstract

Background: Intracranial aneurysms in children and adolescents are uncommon; they account for 0.5% to 4.6% of the total intracranial aneurysms cases.

Methods: A 15-year-old boy presented with a 6-month history of occipital headache that worsened over time. A magnetic resonance imaging scan revealed a giant, fusiform aneurysm of the V4 segment of the right vertebral artery with mass effect but no signs of hemorrhage. This lesion was confirmed by the catheter digital subtraction angiography. The posterior inferior cerebellar artery arose from the distal part of the aneurysm. Two flow-diverter devices were implanted in the V4 segment of the right vertebral artery. Follow-up angiograms performed 1 and 2 years after the procedure revealed a total aneurysm occlusion.

Conclusion: Flow-diverter device implantation may be a viable alternative to parent artery occlusion in a symptomatic, giant, fusiform vertebral artery aneurysm in a child.

Keywords: childhood aneurysm; flow-diverter device; fusiform intracranial aneurysm; vertebrobasilar artery dissection.