title: Treatment of pediatric patient with ruptured intracranial aneurysm--case report.
abstract: BACKGROUND
  Despite the contemporary diagnostics of intracranial aneurysms their treatment is still a great challenge. The decision when and if to apply a surgical or endovascular treatment of intracranial aneurysms should be made by a team of medical specialists which consists of a cerebrovascular neurosurgeon, neuro-radiologist and neuro-anesthesiologist.
  
  
  METHODS
  We report a case of a patient aged 16 who was admitted because of a sudden intensive headache followed by sickness, vomiting, and loss of consciousness. On admission the patient was conscious but sleepy. Glasgow Coma Scale score was 14 and the World Federation of Neurological Surgeons Scale grade was I. The computed tomography scan showed a massive subarachnoid haemorrhage. The computed tomography angiography and digital subtraction angiography revealed a ruptured saccular aneurysm in the left vertebral artery. An early treatment with the coiling of the lumen of the aneurysm was performed under general anaesthesia. On the tenth day the boy was discharged in good condition and without any neurological deficits. Six months after the intervention the patient was without symptoms and the control digital subtraction angiography showed the complete occlusion of the aneurysm.
  
  
  CONCLUSIONS
  Intracranial aneurysms in children are more common in males and are predominantly localized in the posterior circulation. In addition, they are frequently of greater size and more complex architecture and they are associated with a lower incidence of clinically manifest vasospasm. According to previous experience, endovascular treatment of intracranial aneurysms in paediatric patients has proven to be a safe and efficient method with a small number of complications.
authors.affiliation: Department of Pediatric Surgery, Institute for Child and Youth Health Care of Vojvodina, Novi Sad. igor.meljnikov@gmail.com
authors.forename: Igor
authors.initials: I
authors.lastname: Meljnikov
authors.forename: Petar
authors.initials: P
authors.lastname: Vuleković
authors.forename: Tomislav
authors.initials: T
authors.lastname: Cigić
authors.forename: Vladimir
authors.initials: V
authors.lastname: Borisev
authors.forename: Aleksandar
authors.initials: A
authors.lastname: Milojević
authors.forename: Stevan
authors.initials: S
authors.lastname: Iduski
mesh_terms: D000293:Adolescent; D017542:Aneurysm, Ruptured / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D015901:Angiography, Digital Subtraction; D002533:Cerebral Angiography; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D013345:Subarachnoid Hemorrhage / Q000000981:diagnostic imaging / Q000209:etiology; D014057:Tomography, X-Ray Computed; D014711:Vertebral Artery