Ruptured pediatric posterior cerebral artery aneurysm 9 years after the onset of Kawasaki disease: a case report.
METHODS
A 12-year-old boy who had a history of Kawasaki disease 9 years ago experienced a subarachnoid hemorrhage by ruptured right posterior cerebral artery aneurysm. On day 1 operation, as the aneurysm was very fragile and bled easily, two intraoperative ruptures, including a very premature rupture, were encountered. As a result, a left hemiparesis especially severe in the left hand was caused by the right anterior thalamic infarction due to the occlusion of a thalamo-perforating artery arising near the neck of the aneurysm.


CONCLUSIONS
The histopathological examination of the intraoperative excised aneurysmal dome disclosed the thickening of the endothelial inner due to the endothelial hypertrophy and the invasion of inflammatory cells. This finding of the aneurysm was partially mimicking the finding of the coronary artery of the patients with Kawasaki disease. The combination of cerebral aneurysm and Kawasaki disease has never been reported until now, and the etiology of the aneurysm of this patient is unclear.
Tanaka
Satoshi
S
Department of Neurosurgery, Kawasaki Hospital, 2040 Kisaki-nicho, Hitachiohta, Ibaraki, 313-8511, Japan. stanaka-nsu@umin.net
Sagiuchi
Takao
T
Kobayashi
Ikuo
I
D017542:Aneurysm, Ruptured / Q000150:complications* / Q000276:immunology / Q000601:surgery; D002648:Child; D004730:Endothelium, Vascular / Q000276:immunology / Q000473:pathology; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications* / Q000276:immunology / Q000601:surgery; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000150:complications* / Q000276:immunology / Q000473:pathology; D020769:Posterior Cerebral Artery / Q000276:immunology / Q000473:pathology / Q000601:surgery; D013345:Subarachnoid Hemorrhage / Q000209:etiology / Q000276:immunology; D016896:Treatment Outcome