Pediatric Cerebral Aneurysm

Excerpt

One of the earliest recorded cases of a childhood aneurysm was a 15-year-old boy reported by the German pathologist Eppinger in 1871. Postmortem examination revealed stenosis of the aortic isthmus along with the unusual finding of free blood at the base of the brain arising from a ruptured saccular aneurysm of the right anterior cerebral artery. Edvard Bull subsequently described the first antemortem case of a 17-year-old girl who presented with a severe headache and third nerve palsy. The clinical diagnosis of a ruptured posterior communicating artery aneurysm that autopsy subsequently confirmed. Whereas “acquired” factors such as diabetes, alcohol, hypertension, high fat and cholesterol diets, obesity, cigarette consumption, and oral contraceptive use have correlations with subarachnoid hemorrhage in adults, such influences are minimal or altogether absent in children. Several authors have postulated the greater role of congenital factors in the development of childhood aneurysms.