title: Successful coil embolization of a ruptured basilar artery aneurysm in a child with leukemia: a case report.
abstract: Ruptured intracranial aneurysms are rare in the pediatric population compared to adults. This has incited considerable discussion on how to treat children with this condition. Here, we report a child with a ruptured saccular basilar artery aneurysm that was successfully treated with coil embolization. A 12-year-old boy with acute lymphoblastic leukemia and accompanying abdominal candidiasis after chemotherapy suddenly complained of a severe headache and suffered consciousness disturbance moments later. Computed tomography scans and cerebral angiography demonstrated acute hydrocephalus and subarachnoid hemorrhage caused by saccular basilar artery aneurysm rupture. External ventricular drainage was performed immediately. Because the patient was in severe condition and did not show remarkable signs of central nervous system infection in cerebrospinal fluid studies, we applied endovascular treatment for the ruptured saccular basilar artery aneurysm, which was successfully occluded with coils. The patient recovered without new neurological deficits after ventriculoperitoneal shunting. Recent reports indicate that both endovascular and microsurgical techniques can be used to effectively treat ruptured cerebral aneurysms in pediatric patients. A minimally invasive endovascular treatment was effective in the present case, but long-term follow-up will be necessary to confirm the efficiency of endovascular treatment for children with ruptured saccular basilar artery aneurysms.
authors.affiliation: Department of Neurosurgery, Tokyo Medical and Dental University.
authors.forename: Shihori
authors.initials: S
authors.lastname: Hayashi
authors.forename: Taketoshi
authors.initials: T
authors.lastname: Maehara
authors.forename: Maki
authors.initials: M
authors.lastname: Mukawa
authors.forename: Masaru
authors.initials: M
authors.lastname: Aoyagi
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Yoshino
authors.forename: Shigeru
authors.initials: S
authors.lastname: Nemoto
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Ono
authors.forename: Kikuo
authors.initials: K
authors.lastname: Ohno
mesh_terms: D017542:Aneurysm, Ruptured / Q000175:diagnosis / Q000628:therapy*; D001488:Basilar Artery / Q000000981:diagnostic imaging; D058365:Candidiasis, Invasive / Q000150:complications; D002533:Cerebral Angiography; D002648:Child; D004621:Embolization, Therapeutic / Q000379:methods*; D057510:Endovascular Procedures / Q000379:methods*; D006801:Humans; D006849:Hydrocephalus / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D002532:Intracranial Aneurysm / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D008297:Male; D009894:Opportunistic Infections / Q000150:complications; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications*; D013345:Subarachnoid Hemorrhage / Q000209:etiology; D017287:Ventriculoperitoneal Shunt