Infantile ruptured acom aneurysm treated with endovascular stent-coil embolization: case report

TL;DR

A 15-month-old infant with a ruptured brain aneurysm was successfully treated with a minimally invasive stent-coil procedure, leading to full recovery.

Contribution

This case report presents a rare instance of endovascular treatment for a ruptured Acom aneurysm in an infant without hematoma evacuation.

Findings

The infant showed improved symptoms with no neurological sequelae at 1-year follow-up.

MR angiography confirmed no residual aneurysm filling after the procedure.

Abstract

A 15-month-old infant presented with an episode of acute agitation, characterized by crying, refusal to feed, and a focal seizure involving the left arm and leg lasting 1–2 min. Following the seizure, the infant fell asleep but experienced another brief seizure during transport to the hospital. Initial assessment at a private hospital in Mersin, Turkey, led to a referral to our center, where imaging revealed an intraparenchymal hemorrhage in the left frontobasal region. The hemorrhage extended into all ventricles and the right retrosellar area, with notable rightward shift and ventricular enlargement. CTA confirmed a ruptured Acom aneurysm with a bleb. Diagnostic angiography was performed, and an endovascular stent coiling procedure was performed without hematoma evacuation. At 1-year follow-up, patients' symptoms improved without neurological sequelae, and MR angiography revealed no residual filling in the aneurysm.

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