Background

Aneurysms in the pediatric population are uncommon, requiring a high index of suspicion for diagnosis. We report a case of a child with head trauma and delayed diagnosed cerebral aneurysm.

Methods

A 2-year-old girl was brought to the emergency room with seizures. Head imaging showed acute intraventricular hemorrhage, hydrocephalus, and paraclinoid aneurysm of the right internal carotid artery. She had been hospitalized elsewhere 1 month prior for traumatic brain injury after falling to the ground with subarachnoid and intraventricular hemorrhage and good recovery, but without diagnosis of aneurysm.

Results

The child was treated with aneurysm embolization and ventriculoperitoneal shunt, being discharged asymptomatic.

Conclusion

Most primary intraventricular hemorrhage in pediatric population has identifiable etiology. A high rate of clinical suspicion, associated with a low threshold for vascular neuroimaging studies for children with spontaneous or atypical intracranial hemorrhage allow accurate diagnosis, appropriate treatment, and improved outcome.

中文翻译：

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儿科颅内动脉瘤延迟诊断：误诊风险一例

背景

儿科人群中的动脉瘤并不常见，需要高度怀疑才能诊断。我们报告了一例儿童头部外伤和延迟诊断脑动脉瘤的病例。

方法

一名 2 岁女孩因癫痫发作被送往急诊室。头部影像学显示右颈内动脉急性脑室内出血、脑积水和床旁动脉瘤。1个月前因蛛网膜下腔出血和脑室内出血倒地后脑外伤入院，恢复良好，但未确诊为动脉瘤。

结果

患儿经动脉瘤栓塞加脑室腹腔分流术治疗，无症状出院。

结论

儿科人群中的大多数原发性脑室内出血具有可识别的病因。对自发性或非典型颅内出血儿童进行血管神经影像学检查的阈值低，临床怀疑率高，因此诊断准确、治疗适当并改善结果。