Infectious aneurysmal rupture presenting as massive intracerebral hemorrhage in a preterm baby.
BACKGROUND
Infectious intracranial aneurysms in infantile period are very rare, and there is no report of infectious intracranial aneurysm in preterm infant


METHODS
A 43-day-old female infant, delivered at 29 weeks of gestation, presented with massive intracranial hemorrhage. Eighteen days after diagnoses of necrotizing enterocolitis, sepsis, and meningitis, the baby became lethargic with rigid left limbs. Imaging studies revealed a large hematoma in the right temporoparietal region and adjacent lateral ventricle. During removal of fresh hematoma, an actively bleeding nodular mass, contiguous with the distal middle cerebral artery branch, was found and excised from the parent vessel. Pathologic examination revealed a ruptured infectious intracranial aneurysm. After surgery, her neurologic status improved and she was doing well at 12 months' follow-up with mild spastic hemiparesis.


CONCLUSIONS
To our knowledge, this is the first reported case of infectious intracranial aneurysm in the preterm infant, which was successfully treated with hematoma evacuation and resection of the aneurysm.
Kang
Hyun-Seung
HS
Department of Neurosurgery, Konkuk University Hospital, 4-12 Hwayang-dong, Gwangjin-gu, Seoul, 143-729, South Korea.
Lim
So Dug
SD
Koh
Young-Cho
YC
D000785:Aneurysm, Infected / Q000150:complications / Q000473:pathology* / Q000601:surgery; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D002543:Cerebral Hemorrhage / Q000209:etiology* / Q000601:surgery; D020345:Enterocolitis, Necrotizing / Q000188:drug therapy; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D002532:Intracranial Aneurysm / Q000150:complications / Q000473:pathology* / Q000601:surgery; D016920:Meningitis, Bacterial / Q000188:drug therapy; D011247:Pregnancy; D047928:Premature Birth; D018805:Sepsis / Q000188:drug therapy
D000900:Anti-Bacterial Agents; D000935:Antifungal Agents